The primary endpoint was the success rate of adjuvant isonicotinic acid hydrazide (INH) and misoprostol versus misoprostol alone for medical termination of first-trimester pregnancy.

According to the American college of obstetricians and gynecologists (2005), medical abortion is an acceptable alternative for surgical procedures in pregnant women with gestational age of less than 10 weeks based on the last menstrual period

Oral or vaginal misoprostol causes complete abortion in almost 85% of cases within seven days before the 12th week

Adjuvant isonicotinic acid hydrazide (INH) administration with misoprostol raises the rate of complete abortion

Inclusion Criteria:

• Gestational age less than 70 days gestation (<10 wks)
• Hemoglobin >10 g/dL.
• BMI between 18.5 kg/m2 and 30 kg/m2.
• Missed abortion

Exclusion Criteria:

• Molar pregnancy.
• Fibroid uterus.
• Uterine anomalies.
• Coagulopathy.
• Medical disorder that contraindicate induction of abortion (e.g. heart failure).
• Previous attempts for induction of abortion in the current pregnancy.
• Allergy to misoprostol or letrozole.
• Scared uterus (previous myomectomy, cesarean section, hysterectomy and ruptured uterus).

pregnant women with gestational age of less than 10 week

double blind randomized parallel assign controlled trial