Extended Letrozole Protocol Versus Letrozole Plus Inositol for Induction of Ovulation in Letrozole Resistant PCOS Women

Extended Letrozole Protocol Versus Letrozole Plus Inositol for Induction of Ovulation in Letrozole Resistant PCOS Women

Extended letrozole protocol versus letrozole plus Inositol for Induction of ovulation in letrozole resistant PCOS Women

Inclusion Criteria:

• Women diagnosed with polycystic ovary syndrome (PCOS) according to the Rotterdam criteria.
• Letrozole-resistant PCOS patients who failed to ovulate after receiving letrozole 5 mg daily for 5 days for three consecutive cycles.
• Age 18 to 35 years.
• Body mass index (BMI) ≤ 30 kg/m².
• Normal uterine cavity and patent fallopian tubes confirmed by hysterosalpingography (HSG) and/or laparoscopy.
• Partner with normal semen analysis.
• Willing and able to provide informed consent.

Exclusion Criteria:

• Thyroid dysfunction.
• Hyperprolactinemia.
• Diabetes mellitus.
• Congenital adrenal hyperplasia.
• Adrenal causes of hyperandrogenism.
• Use of insulin-sensitizing medications (e.g., metformin) during the study period.
• Chronic liver disease.
• Chronic kidney disease.
• Contraindications to pregnancy.
• Contraindications or hypersensitivity to inositol or letrozole.