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[quote=Anonymous][quote=Anonymous]http://www.cbsnews.com/news/fertility-drug-clomid-success-rate-healthy-births/

"Women in the letrozole treatment group had fewer live births, but four times as many multiple pregnancies as women in the clomiphene group."[/quote]

This study (http://www.nejm.org/doi/full/10.1056/NEJMoa1414827) focuses on the use of letrozole for unexplained fertility and indeed, clomiphene out performs letrozole in terms of clinical pregnancies (28.3% vs. 22.4%), live births (23.3% vs 18.7%). Multiple gestation rate was 22% with clomiphene and 13% with letrozole. These pregnancies were all twins.

However, if the fertility issue is PCOS, Letrozole works better. Letrozole out performs clomiphene in conception (higher conception rate with letrozole), side effects (fewer side effects with Letrozole), chance of multiples (fewer with Letrozole).

Here are a few links to back up the above re: PCOS:
http://www.nejm.org/doi/full/10.1056/NEJMoa1313517
http://www.mdedge.com/obgmanagement/article/88265/reproductive-endocrinology/letrozole-versus-clomiphene-ovulation
https://www.ncbi.nlm.nih.gov/pubmed/25006718

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