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The main finding of this updated systematic review was that it is unclear whether the use of clomiphene citrate CC or letrozole Ltz with gonadotropins, with or without GnRH antagonist, in controlled ovarian stimulation in IVF leads to a difference in live birth rates, ongoing pregnancy rates, or clinical pregnancy rates when compared to the use of gonadotropins with GnRH protocols in either the general population of women undergoing IVF summary of findings Table for the main comparison or in women who are poor responders summary of findings Table 2 viagra over the counter walgreens