Best Treatment for Women With Both (Polycystic Ovary Syndrome) PCOS and Subclinical Hypothyroidism
NCT06041204 · Status: RECRUITING · Phase: NA · Type: INTERVENTIONAL · Enrollment: 200
Last updated 2025-09-03
Summary
The goal of this randomized controlled trial is to compare letrozole alone versus letrozole plus levothyroxine for ovulation induction in infertile women with both PCOS and subclinical hypothyroidism. The main questions it aims to answer are:
Is letrozole plus levothyroxine superior to letrozole alone in achieving ovulation in these patients? Does combining levothyroxine with letrozole lead to higher pregnancy and live birth rates compared to letrozole alone?
Participants will be randomized into two groups:
Group 1 will receive letrozole only, starting at 2.5 mg daily from day 3 to 7 of the menstrual cycle. The dose will be increased up to 7.5 mg if no ovulation occurs, for a maximum treatment period of 6 months or until pregnancy is achieved.
Group 2 will receive letrozole at the same doses as group 1 plus 25 mcg levothyroxine daily.
Conditions
- PCOS (Polycystic Ovary Syndrome) of Bilateral Ovaries
- Subclinical Hypothyroidism
- Female Infertility
Interventions
- DRUG
-
Letrozole 2.5mg
Participants will receive 2.5mg letrozole tablets orally daily for 5 days starting on day 3 of menstrual cycle. The 2.5mg dose will be maintained for at least the first 3 cycles. If no ovulation after 3 cycles, dose cautiously increased up to 7.5mg maximum. Once minimum ovulation dose determined, it will be continued for up to 6 cycles total or until pregnancy occurs. Compliance monitored by pill counts and diary. Ovulation assessed by follicular monitoring and progesterone levels. Routine antenatal care if pregnant. Adverse effects monitored and managed per guidelines. Participants followed for multiple pregnancies. Maximum treatment duration is 6 ovulatory cycles or 6 months. Tablets taken at same time each day.
- DRUG
-
Levothyroxine 25 Mcg (0.025 Mg) Oral Tablet
Participants will take letrozole at same doses as letrozole only group. Also receive levothyroxine starting at 25mcg orally once daily, titrated by 25mcg every 4 weeks to reach normal TSH, maximum 100mcg daily. Once appropriate dose determined to normalize TSH, it is maintained throughout treatment period. Compliance monitored by pill counts, TSH levels, and diary. Treatment continues for up to 6 ovulatory cycles or until pregnancy, whichever is first, maximum 6 months. Ovulation assessed by monitoring and progesterone. Routine antenatal care if pregnant. Adverse effects monitored and managed per guidelines. Participants followed for multiple pregnancies. Letrozole and levothyroxine taken daily at same time. All other procedures same as letrozole only group.
Sponsors & Collaborators
-
Muhamed Ahmed Abdelmoaty Muhamed Alhagrasy
lead OTHER
Principal Investigators
-
Muhamed Alhagrasy, M.D. · Al-Azhar University
Study Design
- Allocation
- RANDOMIZED
- Purpose
- TREATMENT
- Masking
- SINGLE
- Model
- PARALLEL
Eligibility
- Min Age
- 20 Years
- Max Age
- 40 Years
- Sex
- FEMALE
- Healthy Volunteers
- No
Timeline & Regulatory
- Start
- 2021-05-06
- Primary Completion
- 2026-05-30
- Completion
- 2026-06-28
Countries
- Egypt
Study Locations
More Related Trials
-
Letrozole Dose Increments in PCOS Patients Resistant to Letrozole
NCT06403488 ·Status: COMPLETED ·Phase: PHASE3
-
Letrozole or Combined Clomiphene Citrate Metformin as a First Line Treatment in Women With Polycystic Ovarian Syndrome
NCT01679574 ·Status: COMPLETED ·Phase: NA
-
Letrozole Extended vs Traditional Therapy for Ovulation Induction in Women With PCOS (PROLEx-PCOS)
NCT07159880 ·Status: RECRUITING ·Phase: NA
-
the Effect of Clomiphene Citrate Plus Estradiol Valerate Versus Letrozole on Endometrial Thickness and Pregnancy Rate in Infertile Women
NCT04619914 ·Status: COMPLETED ·Phase: NA
-
Combined Letrozole and Clomid in Women With Infertility and PCOS
NCT02802865 ·Status: COMPLETED ·Phase: PHASE4
-
Letrozole or Combined Metformin Clomiphene Citrate (CC) for Women With CC Resistant Polycystic Ovary Syndrome
NCT00911313 ·Status: COMPLETED ·Phase: NA
-
Letrozole or Laparoscopic Ovarian Diathermy for Women With CC Resistant Polycystic Ovary Syndrome.
NCT00956267 ·Status: COMPLETED ·Phase: NA
-
Ovulation Induction in Clomiphene Citrate Resistant PCO Women
NCT02341703 ·Status: COMPLETED ·Phase: EARLY_PHASE1
-
Letrozole and Cabergoline Versus Letrozole Alone in Ovulation Induction
NCT07168837 ·Status: COMPLETED ·Phase: NA
-
Letrozole vs Clomiphene Citrate for Induction of Ovulation in Women With Polycystic Ovarian Syndrome
NCT05702957 ·Status: COMPLETED ·Phase: PHASE2/PHASE3
-
Cabergoline & Letrozole Versus Letrozole in Ovulation Induction in PCOS
NCT07255911 ·Status: RECRUITING ·Phase: NA
-
Clomiphene Citrate Plus uFSH Versus Aromatase Inhibitor Plus uFSH in Clomiphene Resistant Infertile PCOS Women
NCT01793038 ·Status: UNKNOWN ·Phase: NA
-
Comparison of Clomid and Lezra With Lezra for Ovulation Induction in Clomid Resistant PCOS Case
NCT06813118 ·Status: COMPLETED ·Phase: PHASE1
-
Adjuvant Therapy With Letrozole in Induction of Ovulation With Polycystic Ovarian Syndrome
NCT06405178 ·Status: NOT_YET_RECRUITING ·Phase: PHASE3
-
Laparoscopic Ovarian Drilling Versus Letrozole In Clomiphene Citrate Resistant Polycystic Ovary
NCT03664050 ·Status: UNKNOWN ·Phase: PHASE3
-
Ovulation Induction in Women With Clomiphene Citrate Resistant PCOS
NCT01909141 ·Status: COMPLETED ·Phase: EARLY_PHASE1
-
Comparison Between Letrozole and Laparoscopic Ovarian Drilling in Women With Clomiphene Resistant Polycystic Ovarian Syndrome (PCOS)
NCT02305693 ·Status: UNKNOWN ·Phase: PHASE3
-
Efficacy of Letrozole Versus Clomiphene Citrate on Ovulation Induction in Patients With Polycystic Ovarian Syndrome
NCT05075863 ·Status: COMPLETED ·Phase: NA
-
Letrozole Step up Protocol for Ovulation Induction in Infertile Women With Polycystic Ovary Syndrome
NCT07143682 ·Status: COMPLETED ·Phase: PHASE3
-
Comparison Between Two Different Protocols in Polycystic Ovary Symdrome Women Undergoing Intra-cytoplasmic Injection
NCT04094467 ·Status: UNKNOWN ·Phase: PHASE4
-
Letrozole Versus Gonadotropins in Clomiphene Citrate Resistance
NCT04834791 ·Status: COMPLETED ·Phase: PHASE4
-
Pioglitazone Versus Metformin as First Treatment in Infertile Women With Polycystic Ovary Syndrome
NCT03566225 ·Status: COMPLETED ·Phase: EARLY_PHASE1
-
Effect of ALA Combined With Letrozole on Polycystic Ovary Syndrome Clinical Outcome in Infertile Females
NCT06418347 ·Status: RECRUITING ·Phase: PHASE3
-
Comparing the Effect of Metformin vs. Pep2dia as an Adjunct to Letrozole on Ovulation Induction and Pregnancy Outcomes in Overweight Women With PCOS
NCT06452511 ·Status: COMPLETED ·Phase: EARLY_PHASE1
-
A Comparison of Letrozole and Clomifene Citrate
NCT02647424 ·Status: UNKNOWN ·Phase: NA