Letrozole step-up protocol: the effect of a noval superovualtion induction protocol to enhance pregnancy rate in a couple with unexplained infertility undergoing intrauterine inssemination.

prospective randomized trial that included 100 couples with unexplained infertility agreed to continue with intrauterine inssemination (IUI ) All participants were extensively counseled about the risks and benefits of each type of treatment and an informed consent was obtained. 50 Patients received a daily dose of letrozole (Femara; Novartis) tablets orally beginning on day 3 of menstrual cycle with 2.5 mg (1 tab) which is then increased in a step up fashion to 5 mg (2 tabs), 7.5 mg (3 tabs) and finally 10 mg (4 tabs) on days 4, 5 and 6 of the menstrual cycle (Total duration of treatment will be four days starting from third day of mensis). all participants of this group will be followed up by transvaginal ultrasonography starting from day 7 menstrual cycle every 3 days until one dominant follicle reaches a size of 17 mm hence HCG will be given intramuscular in a dose of 10000 iu followed by IUI 36 hours later .