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Study Treatment Cycle
If ovulatory- Await menses/pregnancy If anovulatory- Increase dose
Pregnant: Follow till viable IUP at site and
Track Pregnancy to End
Monthly Menses Visit (Day 1-3) or Missed Menses
Study Medication/ Regular intercourse
Midluteal Visit
Serum hCG
1-3 pills/day x 5 days Start LTZ 2.5 mg/day CC 50 mg/d
Intercourse 2-3x/ week
Serum Progesterone and AMH (Last Visit)
Ultrasound exam for AFC, cysts, ovarian size, endometrial thickness
Primary Outcome: Live Birth
Rate Ratio for Live Birth (LTZ vs CC), 1.44; 95% confidence interval, 1.10 to 1.87
Letrozole 27.5%
Clomiphene 19.5%
Legro et al, NEJM, 2014
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