Aromatase inhibitors (letrozole) for subfertile women with polycystic ovary syndrome

Franik, Sebastian; Eltrop, Stephanie; Kremer, J.A.M.; Kiesel, L.; Farquhar, Cindy

doi:10.1002/14651858.cd010287.pub3

Cited by 111 publications

(113 citation statements)

References 75 publications

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“…CC is given orally and is relatively safe and inexpensive, but there are also adverse effects associated with it, such as negative changes in endometrium and cervical mucus due to the down regulation of oestrogen receptors that might impair implantation after successful induction of ovulation. 3 Aromatase inhibitors (AIs) are a newer class of drugs that were introduced for ovulation induction in 2001 by Mitwally and Casper. 5 Since about 2001 data from many clinical trials have been collected and there is evidence that the AI letrozole might be as effective as CC, but the outcome data vary.…”

Section: Resultsmentioning

confidence: 99%

“…DiscussionIn our study, we tried to compare the effects of letrozole in patients of PCOS and non-PCOS infertile women with due emphasis on the endometrial response and follicular maturation. PCOS is the most common cause of infrequent periods (oligomenorrhoea) and absence of periods (amenorrhoea), affecting about 4% to 8% of women worldwide in their fertile years 3. …”

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confidence: 99%

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Transvaginal sonographic assessment of follicular development and endometrial thickness in letrozole stimulated cycles of PCOS and non-PCOS infertile women

2019

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Background: Infertility in polycystic ovary syndrome (PCOS) is one of the leading causes of anovulatory infertility. Ovulation induction is indicated for the management of anovulatory infertility in PCOS and for augmentation of ovulation in ovulatory infertility, in unexplained infertility. The aim of this retrospective study was to compare and determine the efficacy of letrozole administration in infertile women with PCOS to that of infertile women without PCOS by transvaginal sonography. Methods: This retrospective study was done at Centre for Assisted Reproduction (CARE), BIRDEM General Hospital 2 from January to December 2011. Fifty six infertile women including 16 diagnosed as having PCOS and 40 infertile women with regular menstrual cycle (non-PCOS) were included in this study. Patients were treated with letrozole 7.5 mg/day from day 2-6 of the menstrual cycle. Subjects were monitored once during the days 11 to 14 of the cycle by transvaginal ultrasound. Main outcome measures were number of ovulatory follicles, dominant follicle diameter and endometrial thickness. Results: Letrozole as an ovulation inducing drug was found equally effective in terms of follicular recruitment, follicular maturation and endometrial development both in PCOS and non-PCOS women, as there was no significant difference regarding mature follicular development and endometrial response between the two study groups. Association of endometrial response particularly with follicular diameter 18 mm or more among the study groups revealed no statistically significant difference. Conclusion: In conclusion, our results indicate that the effect of letrozole on endometrial thickness and follicular development in patients of anovulatory PCOS did not significantly differ compared to non-PCOS infertile women. Birdem Med J 2019; 9(3): 234-239

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Section: Resultsmentioning

confidence: 99%

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confidence: 99%

Transvaginal sonographic assessment of follicular development and endometrial thickness in letrozole stimulated cycles of PCOS and non-PCOS infertile women

2019

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“…Letrozole followed by timed intercourse improves live birth rate and clinical pregnancy rates compared with CC with no difference in rates of ovarian hyperstimulation syndrome (OHSS) and reduced multiple pregnancy. 66 Regulations, however, vary internationally on use of letrozole for treatment of infertility and treatment is usually off-label requiring explanation and consent.…”

Section: Treatment Of Reproductive Outcomesmentioning

confidence: 99%

A Summary on Polycystic Ovary Syndrome: Diagnostic Criteria, Prevalence, Clinical Manifestations, and Management According to the Latest International Guidelines

et al. 2018

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Polycystic ovary syndrome (PCOS) is a common hormonal condition with reproductive, metabolic, and psychological sequelae. The Rotterdam Criteria are now internationally accepted, with different phenotypes recognized with varying clinical presentations and risk profiles. The complexity of the disorder, and the impact on quality of life, requires timely diagnosis, screening for complications and management strategies. PCOS remains underdiagnosed and women experience significant delays to diagnosis. Effective dissemination of evidence-based management is therefore vital. In this review, we summarize key aspects of PCOS as a prelude to this issue of on PCOS which focuses on the development of the international evidence-based guideline on the assessment and management of PCOS and the related translation program. We cover diagnostic criteria, prevalence, phenotypes, reproductive, metabolic, and psychological factors of PCOS. We also cover management strategies including lifestyle interventions as well as treatment of nonreproductive outcomes and reproductive outcomes informed by the latest international evidence-based guidelines.

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“…PCOS patients are prone to develop multiple follicles and suffer from OHSS during ART, rendering FET the best choice in most cases. Strikingly, letrozole has the ability to promote monofollicular development and reduce the incidence of OHSS in PCOS patients undergoing ART [10,43,44]. Therefore, we propose a hypothesis that emphasises the benefits of letrozole as the better option to prepare the endometrium in PCOS patients.…”

Section: Discussionmentioning

confidence: 98%

Pregnancy Outcomes Following Letrozole Use in Frozen-thawed Embryo Transfer Cycles: A Systematic Review and Meta-analysis

Chen

Shen

et al. 2020

Geburtshilfe Frauenheilkd

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While widely used for ovulation induction in assisted reproductive technology, the clinical efficacy of letrozole for endometrial preparation prior to frozen-thawed embryo transfer (FET) cycles remains yet to be elucidated. We performed a meta-analysis to compare pregnancy outcomes after letrozole use with those of other endometrial preparation protocols in patients undergoing FET. PubMed, Scopus, Embase and the Cochrane Library were searched for eligible studies. Clinical pregnancy rate (CPR), live birth rate (LBR) and birth defect rate (BDR) were analysed using odds ratio (OR) and 95% confidence interval (CI). A total of 10 studies representing 75 968 FET cycles were included. Comparable CPR and LBR were observed when comparing letrozole administration with natural cycle (OR 1.24, 95% CI: 0.69 – 2.24; OR 1.18, 95% CI: 0.60 – 2.32), artificial cycle (OR 1.46, 95% CI: 0.87 – 2.44; OR 1.39, 95% CI: 0.77 – 2.52), and artificial cycle with gonadotropin-releasing hormone agonist suppression (OR 1.11, 95% CI: 0.78 – 1.59; OR 1.18, 95% CI: 0.82 – 1.68). Pooled results of the limited studies comparing letrozole with human menopausal gonadotropin demonstrated a similar CPR between groups (OR 1.46, 95% CI: 0.29 – 7.21, two studies), but the letrozole group had a statistically lower LBR (OR 0.67, 95% CI: 0.52 – 0.86, one study). No increased BDR was observed in the letrozole group compared to natural cycles or artificial cycles (OR 0.98, 95% CI: 0.60 – 1.61; OR 1.39, 95% CI; 0.84 – 2.28). This pooled analysis supports the use of letrozole as an efficacious and safe alternative to mainstream regimens for endometrial preparation in FET cycles.

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Aromatase inhibitors (letrozole) for subfertile women with polycystic ovary syndrome

Abstract: Aromatase inhibitors (letrozole) for subfertile women with polycystic ovary syndrome (Review)

Cited by 111 publications

References 75 publications

Transvaginal sonographic assessment of follicular development and endometrial thickness in letrozole stimulated cycles of PCOS and non-PCOS infertile women

Transvaginal sonographic assessment of follicular development and endometrial thickness in letrozole stimulated cycles of PCOS and non-PCOS infertile women

A Summary on Polycystic Ovary Syndrome: Diagnostic Criteria, Prevalence, Clinical Manifestations, and Management According to the Latest International Guidelines

Pregnancy Outcomes Following Letrozole Use in Frozen-thawed Embryo Transfer Cycles: A Systematic Review and Meta-analysis

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