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Korean Journal of Obstetrics & Gynecology 2006;49(8):1723-1731.
Published online August 1, 2006.
A comparison of the effect of Anastrozole and Clomiphene citrate in anovulatory patients.
Jae Seok Yang, E Hwa Yoo, Jin Yong Lee, Seo Yoo Hong, Jung Hwan Shin, Cheol Hong Park, Eun Joo Park, Yong Soo Seo, Won Il Park
Department of Obstetrics and Gynecology, Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea. pwi3110@eulji.or.kr
To compare the clinical effectiveness of Anastrozole in ovulation induction with that of clomiphene citrate. METHODS: Sixty anovulatory women were randomly divided into 4 groups (1 mg, 2 mg and 4 mg of Anastrozole groups and Clomiphene citrate group). The ovulation induction was tried with 3 dosages of Anastrozole or 100 mg of Clomiphene citrate for 5 days. The serum level of estradiol, testosterone, FSH and LH were serially monitored (on 3rd, 5th and 8th days of treatment). Serum estradiol level at the time of hCG injection was also measured. Ovulation rate, number of dominant follicles, endometrial thickness, and pregnancy rate were measured and compared across the study groups. RESULTS: There was no statistically significant difference in estradiol, testosterone, or LH level between women treated with Anastrozole and Clomiphene citrate. In patients treated with 4 mg of Anastrozole, serum FSH level was higher than that of the women treated with Clomiphene citrate (P<0.05). Endometrial thickness was greater in patients treated with Anastrozole than women treated with Clomiphene citrate (P<0.05). Number of dominant follicles in patients treated with Clomiphene (1.56) was slightly greater than in women treated with Anastrozole (1.0-1.1), but there was no statistically significant difference. CONCLUSION: Anastrozole had similar clinical effectiveness in ovulation induction when compared to Clomiphene citrate. At 1 mg or 2 mg of Anastrozole, ovulatory rate remained below the effectiveness of Clomiphene citrate, therefore considering the expensive cost of Anastrozole, it should not be considered as first-line medication for ovulation induction but reserved for those who have certain conditions such as thin endometrium and polycystic ovarian syndrome.
Key Words: Aromatase inhibitor, Anastrozole, Clomiphene citrate, Ovulation induction

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