TAMOXIFEN PROVIDES COMPARABLE REPRODUCTIVE OUTCOMES AND IMPROVED ENDOMETRIAL DEVELOPMENT COMPARED WITH CLOMIPHENE CITRATE: FINDINGS FROM A THREE-ARM RANDOMIZED TRIAL IN WOMEN WITH POLYCYSTIC OVARY SYNDROME

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age, with an estimated prevalence of 8-13%, depending on the diagnostic criteria used. It is characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology, and is responsible for approximately 70-80% of cases of anovulatory infertility. Beyond reproductive dysfunction, PCOS is associated with obesity, insulin resistance, type 2 diabetes mellitus, metabolic syndrome, and adverse psychological outcomes, making it a chronic multisystem disorder requiring individualized management.1,2 Ovulation induction remains the cornerstone of infertility treatment in women with anovulatory PCOS after exclusion of other causes of infertility. The principal objectives are to achieve monofollicular ovulation, maximize the likelihood of pregnancy, and minimize complications such as multiple pregnancy and ovarian hyperstimulation syndrome(OHSS). Lifestyle modification, particularly weight reduction in overweight and obese women, is recommended as the initial intervention because even modest weight loss may restore spontaneous ovulation and improve reproductive outcomes.2