Committee Opinion No. 663

doi:10.1097/aog.0000000000001484

Cited by 21 publications

(5 citation statements)

References 40 publications

(31 reference statements)

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“…The most well-known AIs include anastrozole, letrozole, and fadrozole. They are mainly used in the treatment of gynecological cancers [ 100 ]. Their efficacy in UF treatments has also been confirmed [ 84 ] ( Figure 3 ).…”

Section: Discussionmentioning

confidence: 99%

Role of Transforming Growth Factor β in Uterine Fibroid Biology

Ciebiera

Włodarczyk

Wrzosek

et al. 2017

IJMS

109

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Uterine fibroids (UFs) are benign tumors of the female genital tract made of the smooth muscle of the uterus. UF growth depends mostly on the influence of the steroid hormones and selected growth factors. Transforming growth factor β (TGF-βs) is a polypeptide that consists of three isoforms: TGF-β1, TGF-β2, and TGF-β3. At present, TGF-β is considered to be one of the key factors in the pathophysiology of UFs. It plays a major role in cellular migration within the tumor, stimulates tumor growth, and enhances tumor metabolism. As a consequence of various dependencies, the synthesis and release of TGF-β in a UF tumor is increased, which results in excessive extracellular matrix production and storage. High concentrations or overexpression of TGF-β mediators may be responsible for clinically symptomatic UFs. The aim of this review was to check the available evidence for the influence of the TGF-β family on UF biology. We conducted their search in PubMed of the National Library of Medicine with the use of the following selected keywords: “uterine fibroid”, “leiomyoma”, and “transforming growth factor β”. After reviewing the titles and abstracts, more than 115 full articles were evaluated. We focused on the TGF-β-related molecular aspects and their influence on the most common symptoms that are associated with UFs. Also, we described how the available data might implicate the current medical management of UFs.

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Section: Discussionmentioning

confidence: 99%

Role of Transforming Growth Factor β in Uterine Fibroid Biology

Ciebiera

Włodarczyk

Wrzosek

et al. 2017

IJMS

109

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“…Nevertheless, studies that are more recent could not find an adverse effect on embryological, clinical or neonatal data for oocytes with smooth endoplasmic reticulum aggregates, since more than 20 children were born from oocytes with this abnormality. Moreover, the exclusion of these oocytes from ICSI cycles causes an increased frequency of transfer cancellation (Ashrafi et al, 2015;Shaw-Jackson et al, 2014;2016;Restelli et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

“…Letrozole is an aromatase inhibitor (AI) developed in the 1990's, as an adjuvant in women with positive estrogen-receptor metastatic breast cancer, as it blocks catalytic conversion of androstenedione to estrone, and testosterone to estradiol ( Rodriguez-Wallberg & Oktay, 2010 ; Halászová et al ., 2017 ; Rodgers et al ., 2017 ). As a selective and reversible AI, it inhibits proliferation of estrogen-dependent breast cancer cells, promoting reduction of tumor recurrence and higher disease-free survival rates when administered as long-term adjuvant therapy ( Rodgers et al ., 2017 ; ACOG, 2016 ; Dahhan et al ., 2017 ; Taylan & Oktay, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

The impact of letrozole administration on oocyte morphology in breast cancer patients undergoing fertility preservation

Bercaire

Cavagna

Donadio

et al. 2020

JBRA Assisted Reproduction

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Objective: Patients submitted to oncological fertility preservation with letrozole and gonadotropins seem to present a higher rate of immature oocytes and lower fertilization rates in comparison to infertile patients submitted to IVF cycles with gonadotropins. The aim of this study was to evaluate the influence of letrozole on oocyte morphology in patients with breast cancer submitted to fertility preservation. Methods: Retrospective analysis performed at a public tertiary hospital in São Paulo, Brazil. The oocytes were retrieved from patients with breast cancer undergoing fertility preservation (n=69), and from infertile women undergoing in vitro fertilization (n=92). We evaluated 750 oocytes obtained from breast cancer patients submitted to ovarian stimulation with letrozole and gonadotropins, and 699 oocytes from patients without breast cancer submitted to ovarian stimulation for in vitro fertilization with gonadotropins only due to male factor infertility. The mature oocytes retrieved were analyzed for the presence of refractile bodies, ooplasm color and regularity, central granulation degree, cortical granules, zona pellucida staining and regularity, perivitelline space, presence of vacuoles or abnormal smooth-surfaced endoplasmic reticle and oocyte retraction. Results: There was a higher incidence of alterations in oocyte morphology in the letrozole group when compared to the control group: increased perivitelline space ( p =0.007), irregular zona pellucida ( p <0.001), refractile bodies ( p <0.001), dark ooplasm ( p <0.001), granular ooplasm ( p <0.001), irregular ooplasm ( p <0.001) and dense central granulation ( p <0.001). Conclusion: Letrozole is a risk factor for worse oocyte morphology. However, the clinical impact of ovarian stimulation protocol with combined use of gonadotropins and letrozole for fertility preservation remains unclear in this setting. These data underline the importance of establishing the predictive potential of morphological dimorphisms of human oocytes in IVF outcomes.

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“…The most well-known AIs are anastrozole, letrozole, and fadrozole. They are mainly used in the treatment of gynecological cancers (breast or endometrial cancer) [ 104 ], to suppress estrogen production [ 104 ], and to treat endometriosis [ 105 , 106 , 107 ] or infertility (induction of the ovulation) [ 107 ]. AIs have good efficacy, but they can cause common side effects, such hot flashes, bone loss, mood swings, vaginal dryness, ovarian cyst formation, or body pain [ 108 ].…”

Section: Discussionmentioning

confidence: 99%

Alternative Oral Agents in Prophylaxis and Therapy of Uterine Fibroids—An Up-to-Date Review

Ciebiera

Łukaszuk

Męczekalski

et al. 2017

IJMS

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Uterine fibroids (UFs) are the most common tumors of the female genital tract. The effect of UFs on the quality of life and the overall cost of treatment are significant issues worldwide. Tumor size and location are the two specific factors which influence the occurrence of symptoms, the need for, and method of, treatment (some tumors require surgery while some can be treated with selected drugs). Primary prevention and treatment of early UF disease are worthy goals that might have a great impact on health care systems. Several treatments and prophylactic methods can be used in this endeavor. This publication presents current data about lesser-known substances which may have a beneficial effect on the treatment or prophylaxis of UFs and can be administered orally, serving as an alternative to (or complement of) surgery or selective progesterone receptor modulators (SPRMs). Early prevention and treatment of UFs in women from high-risk groups should be our priority. Innovative forms of UF management are under intensive investigation and may be promising options in the near future. Many of them evaluated vitamin D, paricalcitol, epigallocatechin gallate (EGCG), elagolix, aromatase inhibitors (AIs), and cabergoline and deemed them to be safe and effective. The next step in such projects should be properly constructed randomized control trials (RCTs), carried out by successive phases.

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Committee Opinion No. 663

Cited by 21 publications

References 40 publications

Role of Transforming Growth Factor β in Uterine Fibroid Biology

Role of Transforming Growth Factor β in Uterine Fibroid Biology

The impact of letrozole administration on oocyte morphology in breast cancer patients undergoing fertility preservation

Alternative Oral Agents in Prophylaxis and Therapy of Uterine Fibroids—An Up-to-Date Review

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