Laboratory and Ultrasound Findings and Response to Letrozole in PCOS Patients

Comparison of Laboratory and Ultrasound Findings Between Letrozole-Resistant and Letrozole-Sensitive PCOS Patients in Egypt

The goal of this observational study is to compare laboratory and ultrasound findings between letrozole-resistant and letrozole-sensitive PCOS patients in Egypt. The study will include women aged 18-40 years diagnosed with PCOS based on the Rotterdam criteria, who are undergoing ovulation induction with letrozole for the first time.

The main questions it aims to answer are:

What are the baseline laboratory and ultrasound differences between letrozole-resistant and letrozole-sensitive PCOS patients? What factors can predict letrozole resistance in PCOS patients? Researchers will compare letrozole-resistant and letrozole-sensitive PCOS patients to determine whether specific laboratory markers and ultrasound findings can predict resistance to letrozole.

Participants will:

Undergo baseline clinical, laboratory, and ultrasound assessments before starting letrozole treatment.

Receive letrozole treatment with dose escalation up to 7.5 mg/day over a maximum of three cycles if ovulation is not achieved.

Be monitored through serial transvaginal ultrasounds to assess follicular development.

Have ovulation confirmed via mid-luteal serum progesterone levels. The study aims to improve the understanding of predictors of letrozole resistance to guide personalized ovulation induction strategies in PCOS patients.

Inclusion Criteria:

• Women aged 18-40 years.
• Diagnosis of PCOS based on Rotterdam criteria.
• No prior ovulation induction with letrozole.
• Willing to follow the treatment protocol and attend follow-up visits

Exclusion Criteria:

• Infertility due to other causes such as tubal obstruction or male factor infertility.
• Previous ovarian surgery or use of medications that could influence ovulation.
• Comorbidities such as uncontrolled diabetes, hyperprolactinemia, or thyroid dysfunction.