Research at the Women's Hospital aims to reduce pregnancy loss among women with polycystic ovary syndrome

In honour of National Gynaecological Awareness Month, we wanted to highlight a clinical trial that the Women's Hospital is conducting in partnership with the University of Birmingham, aiming to improve fertility and reduce pregnancy loss in women with Polycystic Ovary Syndrome (PCOS). One in ten UK women suffers from PCOS, which often results in reduced fertility and an excess of male hormones.


As part of the ‘LOCI’ trial, Letrozole is compared with Clomifene or Metformin and Clomifene is compared with Metformin and Clomifene. Typically, these drugs are used in ovulation induction, encouraging the release of eggs (ova), and enhancing the chances of conception for women with Polycystic Ovary Syndrome (PCOS).



The Women's Hospital aims to recruit 2,100 women across the UK, including women from Birmingham Women's Hospital, between the ages of 18 and 43, with anovulatory PCOS (irregular periods). In this study, Clomifene and Letrozole will be compared against each other to determine which drug combination increases gestational birth rates the most effectively and is the most cost-effective.



According to Lee Priest, Director of Tommy's National Centre for Miscarriage Research and National Clinical Coordinator for the trial, "We will be able to identify the most cost-effective method for ovulation induction through this trial as well as support women with Polycystic Ovary Syndrome. In order to reach our goal and improve fertility treatment for women with PCOS, we have recruited over 850 women, and we hope to recruit many more in the future."



The Chief Investigator of the trial, Professor Arri Coomarasamy, said, "Various small trials have attempted to find out which of the two main ovulation induction drugs (Clomifene and Letrozole) offers the best chances of live birth. However, the evidence is insufficient to draw confident conclusions. In addition to being the largest trial in this field ever conducted, we hope it will contribute to women's health in a meaningful way."



Clomifene has been used to induce ovulation in women with PCOS since the 1960s, while Letrozole has recently become available. It is unclear which of the two drugs is best for increasing the chance of live birth, despite both offering benefits in inducing ovulation. Metformin is also an ovulation inducer that can be combined with Clomifene or Letrozole, but the extent of its benefits is unknown.



In the LOCI trial, we aim to clarify how these drugs can be used to maximize treatment effectiveness for women with PCOS. We'll keep you posted on the results of the LOCI trial and how it may benefit women with polycystic ovary syndrome.



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