OBJECTIVES To evaluate the costs and effectiveness of the conventional drug treatment with clomiphene citrate versus anastrozole in the induction of the ovulation in infertile adult patients attending a Mexican public hospital. METHODS A prospective and descriptive clinical pilot study was conducted in a Mexican public hospital “La Raza” of the Mexican Social Security Institute (IMSS). Thirty adult patients with infertility due to anovulation were recruited and grouped into two groups. Group A was treated with clomiphene citrate and group B with anastrozole for 6 months. A systematic scientific review of the published literature related with the two drugs was done, in order to gather the drug efficacy and adverse effects probabilities. The drug efficacies gathered in the Mexican clinical pilot study and the efficacy data from the literature review were analyzed by means of meta-analysis. The direct medical and non direct medical costs as well as the indirect costs were assessed using a micro-costing process. Using the Mexican women epidemiological data a hypothetic population of 10000 was considered. A time horizon of one year was estimated. The Markov-Montecarlo model-computarized TreeAge Program was used in order to evaluate the cost-effectiveness (CE) ratio. The discount rate, incremental and marginal analyses were done. RESULTS The meta-analysis odds ratio was 0.85 for the ovulation induction and 1.46 for pregnancy. The most CE treatment was clomiphene citrate with a ratio of $173 dollars/QALY versus $192 of anastrozole. The result of the incremental analysis was $18 dollars/QALY. CONCLUSIONS The conventional drug treatment (clomiphene) is the most cost/effective for the present study population. Further investigations are needed in order to assess the costs of adverse events in order to obtain conclusive data.