The goal of this observational study is to compare laboratory and ultrasound findings between letrozole-resistant and letrozole-sensitive PCOS patients in Egypt. The study will include women aged 18-40 years diagnosed with PCOS based on the Rotterdam criteria, who are undergoing ovulation induction with letrozole for the first time. The main questions it aims to answer are: What are the baseline laboratory and ultrasound differences between letrozole-resistant and letrozole-sensitive PCOS patients? What factors can predict letrozole resistance in PCOS patients? Researchers will compare letrozole-resistant and letrozole-sensitive PCOS patients to determine whether specific laboratory markers and ultrasound findings can predict resistance to letrozole. Participants will: Undergo baseline clinical, laboratory, and ultrasound assessments before starting letrozole treatment. Receive letrozole treatment with dose escalation up to 7.5 mg/day over a maximum of three cycles if ovulation is not achieved. Be monitored through serial transvaginal ultrasounds to assess follicular development. Have ovulation confirmed via mid-luteal serum progesterone levels. The study aims to improve the understanding of predictors of letrozole resistance to guide personalized ovulation induction strategies in PCOS patients.
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Comparison of baseline FSH level between letrozole-sensitive and letrozole-resistant PCOS patients.
Timeframe: At the end of cycle 3 of treatment (each cycle is 28 days).
Comparison of baseline LH level between letrozole-sensitive and letrozole-resistant PCOS patients.
Timeframe: At the end of cycle 3 of treatment (each cycle is 28 days).
Comparison of baseline LH/FSH ratio level between letrozole-sensitive and letrozole-resistant PCOS patients.
Timeframe: At the end of cycle 3 of treatment (each cycle is 28 days).
Comparison of baseline AMH level between letrozole-sensitive and letrozole-resistant PCOS patients.
Timeframe: At the end of cycle 3 of treatment (each cycle is 28 days).
Comparison of baseline total testosterone level between letrozole-sensitive and letrozole-resistant PCOS patients.
Timeframe: At the end of cycle 3 of treatment (each cycle is 28 days).
Comparison of baseline fasting insulin level between letrozole-sensitive and letrozole-resistant PCOS patients.
Timeframe: At the end of cycle 3 of treatment (each cycle is 28 days).
Comparison of baseline glucose level between letrozole-sensitive and letrozole-resistant PCOS patients.
Timeframe: At the end of cycle 3 of treatment (each cycle is 28 days).
Comparison of baseline lipid profile between letrozole-sensitive and letrozole-resistant PCOS patients.
Timeframe: At the end of cycle 3 of treatment (each cycle is 28 days).
Comparison of baseline antral follicle count between letrozole-sensitive and letrozole-resistant PCOS patients.
Timeframe: At the end of cycle 3 of treatment (each cycle is 28 days)
Comparison of baseline ovarian volume between letrozole-sensitive and letrozole-resistant PCOS patients.
Timeframe: At the end of cycle 3 of treatment (each cycle is 28 days)