Objective: To compare the efficacy of Clomiphene Citrate and Letrozole in the induction of ovulation in patients with primary ovarian subfertility.

Methodology: This randomized controlled trial was conducted at Dow University Hospital, Ojha Campus, Karachi, from February 2016 to January 2017, following approval of the study synopsis. The required sample size was 164 participants, with 82 women allocated to the Letrozole group and 82 to the Clomiphene Citrate group. Women aged 18–40 years with primary ovarian subfertility were included, irrespective of weight, years of marriage, or duration of subfertility. Participants were randomly divided into two groups using the lottery method. Data were collected and analyzed using SPSS.

Results: A total of 164 women were enrolled, including 82 participants in each treatment group. The mean age was 28.48 ± 4.12 years in the Clomiphene Citrate group and 28.45 ± 3.01 years in the Letrozole group. In the Clomiphene Citrate group, efficacy was observed in 2 (2.4%) participants during the first cycle, 23 (28.05%) during the second cycle, and 32 (39.02%) during the third cycle. In comparison, efficacy with Letrozole was observed in 18 (21.9%) participants during the first cycle, 34 (41.4%) during the second cycle, and 24 (29.2%) during the third cycle. Overall, Letrozole demonstrated a favorable treatment response, particularly during the first and second cycles.

Conclusion: Letrozole appeared to be an effective option for ovulation induction in women with primary ovarian subfertility. Compared with Clomiphene Citrate, Letrozole demonstrated a higher proportion of favorable responses during the earlier treatment cycles. These findings support the use of Letrozole as an alternative option for ovulation induction in women with primary ovarian subfertility.

Urooj Yasir Khan is currently working as an Associate Gynaecologist in the Department of Gynaecology and Obstetrics at Capital Hospital, Islamabad, Pakistan. She has a special interest in reproductive medicine and the management of female subfertility. She has been involved in clinical practice, research, and academic activities in the field of obstetrics and gynaecology. Her areas of interest include infertility management, ovulation induction, and reproductive health. She has participated in academic and research activities and is committed to improving evidence-based approaches to the management of subfertility.