Letrozole for ovulation induction

Letrozole is a more effective promoter of ovulation than clomifene; higher pregnancy rates and less frequent multifollicular development are reported. However, letrozole is not registered by the Australian Therapeutic Goods Administration (TGA) for this indication. Although initial reports suggested a higher congenital abnormality rate in children conceived after letrozole therapy, multiple subsequent studies have not shown any difference in abnormality rates compared to clomifene.

Use of letrozole for ovulation induction requires specialist guidance and monitoring; see Assessing response to ovulation induction. A typical regimen is:

If ovulation does not occur, an increased dose of letrozole is used for each of the next two cycles before considering other drugs.