Is letrozole better than clomiphene for PCOS ovulation induction?
My gynaecologist suggested letrozole. An older report mentioned Clomid. Which is usually preferred now for PCOS?
Short answer: For many women with PCOS, letrozole is preferred over clomiphene for ovulation induction because of higher ovulation and live-birth rates in major studies, with a favourable profile when cycles are monitored.
Answer #1
What the evidence generally shows
Large randomised trials found letrozole produced more ovulations and more live births than clomiphene in women with PCOS. Letrozole also tends to affect the endometrium less negatively. Dose is still individualised and follicles are monitored to limit multiple pregnancy risk.
Dr. Arjun Reddy, MS (OBG), Reproductive Endocrinologist. Answered 2026-07-23
Answer #2
Monitoring is part of treatment
Timed intercourse or IUI works best with ultrasound confirmation of follicle growth and a trigger when indicated. Do not repeat unmonitored cycles indefinitely if there is no response or if multiple large follicles develop.
Dr. Rohan Mehta, MS (OBG), FNB Reproductive Medicine. Answered 2026-07-23
Call your clinic or go to the hospital the same day if you have
- Severe pelvic pain suggesting ovarian torsion
- Visual symptoms or severe headache on clomiphene
- Symptoms of multiple pregnancy later need clinic review
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Answers are general education for patients in India, not a diagnosis or personal medical advice. Best IVF Centers is a fertility matching service, not a clinic or hospital. Always follow your treating doctor's instructions. In an emergency, go to the nearest hospital.