First reported case of sextuplets conceived via letrozole for ovulation induction

Monitoring of follicular growth should be considered in ovulation induction with letrozole to reduce the risk of high-order multiple gestations.

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Gunwant Warraich, M.D., Tannys D.R. Vause, M.D.

Volume 103, Issue 2, Pages 535-536



To report the first case of sextuplets conceived via letrozole during ovulation induction.


Case report.


Private fertility clinic.


32-year-old female with a history of secondary infertility and polycystic ovary syndrome.


Letrozole, 7.5 mg, on cycle days 3–7 after a progesterone-induced menses.

Main Outcome Measure(s):

Clinical pregnancy.


Sexchorionic-sexamniotic pregnancy.


High-order multiple gestations are possible with letrozole ovulation induction, so patients should be counseled appropriately and follicle monitoring considered.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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