Ovulation induction Once bitten twice shy

Robert F. Casper, M.D.

Volume 103, Issue 2, Page 356

Reflections on “First reported case of sextuplets conceived via letrozole for ovulation induction” by Warraich et al.

  • The take-home point of this reflection is the fact that exactly synchronized follicles in PCOS patients may respond at the same time and result in multifollicular ovulation and higher order multiple pregnancies, whether Clomid or Letrozole is used. This begs the question: Should generalist Ob/Gyns with no easy access to ultrasound monitoring continue to do ovulation induction cycles in patients with PCOS?

    • Robert Casper

      Hi Alex,

      I agree. That is the question. However, a single ultrasound around day 10 or 12 of the cycle is likely enough to determine if multiple preovulatory follicles are present and whether it is safe or not to have intercourse. That should be possible to arrange ahead of time in almost any location.



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