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Letrozole + recombinant FSH is a combination protocol used primarily in the management of infertility, especially for women with anovulatory infertility such as polycystic ovary syndrome (PCOS) or for ovarian stimulation in assisted reproductive technologies (ART) including intrauterine insemination (IUI) and in vitro fertilization (IVF). **Letrozole** is a third-generation aromatase inhibitor that lowers estrogen levels, thereby releasing hypothalamic-pituitary inhibition and increasing endogenous FSH release. **Recombinant FSH** (rFSH) directly stimulates the ovaries to promote follicular development. The combination is designed to reduce the dose of FSH required, improve monofollicular development (thus reducing risks of multiple pregnancies and ovarian hyperstimulation syndrome), and lower circulating estrogen levels. The regimen is especially used in women at risk for ovarian hyperstimulation or with poor ovarian response[1][2][3].
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