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To compare the effects of metformin - Clomiphene citrate (CC) and metformin – letrozole on follicular and endometrial response in infertile polycystic ovary syndrome patients. The patients were visited infertility clinic and examined by gynecologists. Healthy normal cycled women conclude as a control ( group I), untreated PCOS patients selected for (group II), All patients of both groups (III and IV) were received 1500 mg metformin (Glucophage, Merck, West Drayton, UK) per day (500 mg three times a day) for 6–8 weeks. If pregnancy occurred, the patient was excluded from the study. However, in case of failure of pregnancy at the end of this period, the patients in Group III were received 100mg of clomophene citrate and Group IV were received 2.5 mg letrozole (Femara, Novartis, Quebec, Canada) for 5 days from day 3 of their menstrual cycle. In this study, the mean levels of glucose, Insulin, FSH and LH decreased significantly (p<0.001) in treated groups. The mean levels of estrdiol (E2), progesterone (p) were significantly (p<0.001) suppressed and inhibin B were significantly (p< 0.001) improved after the treatment period. The result demonstrates that the total number of matured follicles and endometrial thickness also significantly (p< 0.001) increased in treated subjects. The combined effect of metformin - letrozole showed a significantly better follicular and endometrial response compared with metformin - Clomiphene citrate (CC).
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