Induction of Abortion in the First Trimester by Misoprostol or Misoprostol With Letrozole

Background: Management of abortion is an important issue in gynecology. Several millions of spontaneous abortions occur yearly and more than a million induced abortions are performed in the USA. Objectives: The aim of this study was to compare the effect of misoprostol alone and misoprostol with letrozole in the induction of abortion in the first trimester of pregnancy in the Qazvin city of Iran. Patients and Methods: Seventy female candidates for legal abortion within the first trimester of pregnancy were divided to two groups: misoprostol alone and misoprostol with letrozole. The complete abortion, time to open the internal os of the cervix, time to complete the abortion, and drug-induced side effects of misoprostol and letrozole were recorded and analyzed. Results: The complete abortion rate was 69.7% in the misoprostol and letrozole group and 30.3% in the misoprostol group. Incomplete abortion was 32.4% in the misoprostol and letrozole group, and 67.6% in the misoprostol group (P = 0.004). Bleeding, cervix os opening time, and time to complete abortion from induction of drugs were similar in both groups (P > 0.05). There were no medical complications in both groups. Conclusions: Misoprostol plus letrozole was more effective for inducing abortion in the first trimester of pregnancy compared to misoprostol alone.