CLINICAL EFFICACY OF LETROZOLE STEP-UP PROTOCOL VERSUS CONVENTIONAL DOSAGE FOR OVULATION INDUCTION IN INTRAUTERINE INSEMINATION AMONG WOMEN WITH UNEXPLAINED INFERTILITY: A RANDOMIZED CONTROLLED TRIAL

Abstract

This study compares the efficacy of letrozole step-up protocol and conventional dosage for ovulation induction in intrauterine insemination (IUI) among women with unexplained infertility. Sixty participants were randomized into two groups: Group A received step-up letrozole dosing (starting 2.5 mg with daily increments) and Group B received a fixed dose of 5 mg daily. Outcomes included ovulation rates, follicular development, cycle cancellation, and pregnancy rates. Group A showed a slightly higher ovulation rate (95.06% vs. 93.59%) and total dominant follicles per cycle (77 vs. 74) with a lower cancellation rate (4.94% vs. 6.41%). Pregnancy rates were comparable initially (10% in both groups) but favored Group A in subsequent cycles (16.66% vs. 13.33%). Both protocols were effective, but the step-up regimen demonstrated sustainable cycle viability and follicular response benefits. These findings support the step-up protocol as a viable option in clinical practice.