Letrozole Versus Clomiphene Citrate for Ovulation Induction in Women With Poly Cystic Ovary Syndrome ( PCOS )

110 infertile women diagnosed as polycystic ovary syndrome (PCOS) at the age group of 20-35 distributed randomly : * 55 women will receive letrozole 2.5mg twice daily orally from the 2nd day to the 6thday of the cycle for three successive cycles. * 55 women will receive clomiphene citrate 50 mg twice daily orally from the 2nd day to the 6thday of the cycle for three successive cycles. Patients will be subjected to: Complete history taking: 1. Details about name, age 2. Menstrual history with determination of menarche 3. Amenorrhea or oligomenorrhea , Regularity of the cycle 4. History of endocrine disease. 5. History of previous operations. * Physical examination: * General examination: With special concern to: --Acne. --Hirsutism . --Weight. --Height --BMI was determined : Wt. in kg ـــــــــــــــــــ = ) Height in m)2 \- Abdominal examination : * for scar of previous pelvic or abdominal operations . * Pelvic examination : * vaginal examination for enlarged cystic ovaries. * ultrasound for diagnosis of pcos. PARAMETERS: (1) rate of ovulation (primary parameter). (2) serum progesterone level on day 21. (3) number of mature follicles produced per cycle. (4) mean endometrial thickness. (6) chemical pregnancy. (7) ongoing pregnancy

Sex

Female

Minimum age

20 Years

Maximum age

35 Years

Inclusion Criteria:

1. Age between 20-35
2. Primary or secondary infertility
3. Patients diagnosed as PCOs according to Rotterdam criteria (Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group.,2003)

Exclusion Criteria:

Any patients have any causes of infertility other than which mentioned in the inclusion criteria as:

1. Hyperprolactinemia.
2. Male factor of infertility.

   WHO Guidelines 2010 for Normal seminal fluid analysis :
   * Volume\> 1.5 ml
   * ph 7.2 to 8.0
   * Liquefaction time 20 to 30 min
   * Sperms concentration \>15 million/ml
   * Total motility 40%(Progressive motility + non progressive motility)
   * Progressive motility 32%
   * Morphology \> 4% normal forms
3. Thyroid dysfunction.
4. Diabetes Mellitus.
5. Known or suspicious tubal factor infertility by HSG or laparoscope.
6. Endometrioses or pelvic inflammatory diseases .