Comparison of ovulation induction with letrozole plus dexamethasone and letrozole alone in infertile women with polycystic ovarian disease: An RCT
Background: Infertility is characterized by the inability to obtain a successful pregnancy after 6 months or more with unprotected and regular intercourse. In developing countries, the incidence of infertility is 2%. The causes of infertility could be male factor or female factor, or mixed factor.
Objective: This study was conducted with the aim of comparison the ovarian response to letrozole alone and letrozole plus dexamethasone in infertile women with poly cystic ovarian disease (PCOS).
Materials and Methods: This randomized clinical trial was conducted on 120 infertile women with PCOS referred to Ali-Ebne-Abitaleb hospital, Zahedan, Iran from February to August 2017 into two groups: group I received letrozole alone and group II recived letrozole plus dexamethasone. The endometrial thickness, follicle diameter, and ovulation were evaluated and compared by ultrasound on days 12 to 14.
Results: The mean thickness of endometrium was not different between two groups. Pregnancy rate was 8% in letrozole group and 23% in Letrozole plus Dexamethasone (p = 0.024). Also, the mean diameter of follicles in two groups were not statistically significant.
Conclusion: Overall, this study showed that dexamethasone may increase pregnancy rate.
Key words: Letrozole, Dexamethasone, PCOS, Induction ovulation.
 Behnoud N, Bahrami R, Kordafshari G, Farzaneh F, Mohammadi Kenari H. Management of early menopause using traditional Persian medicine. A case report. Int J Women’s Health Reprod Sci 2019; 7: 231–236.
 Behnoud N, Farzaneh F, Ershadi S. The effect of clomiphene citrate versus letrozole on pregnancy rate in women with polycystic ovary syndrome: A randomized clinical trial. Crescent J Med Biol Sci 2019; 6: 335–340.
 Behnoud N, Rezaei R, Esform E, Farzaneh F. The relationship between endometrial thickness and endometrial pattern with pregnancy rate based on positive serum beta-human chorionic gonadotropin. Int J Women’s Health Reprod Sci 2019; 7: 400–403.
 Teimoori B, Esmaeilpoor M, Khaefi Ashkezari A, Farzaneh F. Comparison of induction abortion in the first trimester using misoprostol alone and misoprostol with estrogen priming. Int J Women’s Health Reprod Sci 2019; 7: 404–407.
 Al-Shaikh SF, Fadhil I. [Prednisolone with clomiphene citrate in ovulation induction in clomiphene citrateresistant polycystic ovary syndrome]. Med J Babylon 2010; 7: 571–578. (in Arabic)
 Begum MR, Ehsan M, Begum MS, Khan F, Baby HA, Siddiqui M, et al. Beneficial effects of addition of glucocorticoid during induction of ovulation by letrozole in polycystic ovarian syndrome. J South Asian Federation Obstet Gynecol 2012; 4: 85–89.
 Ashrafi M, Zafarani F, Tehrani E, Owj M, Baghestani AR, Amirchaghmaghi E. [Effect of Dexamethasone on ovarian response in infertile women aged over 35 years undergoing IVF/ICSI program]. Med J Reprod Infertil 2004; 5: 308–314. (in Persian)
 Shabana AA, Al-Halby AE, Shaheen AH, El-Naggar AM. Letrozole with dexamethasone versus clomiphene citrate with dexamethasone for induction of ovulation in polycystic ovary. Menoufa Med J 2018; 31: 38–45.