Endometrial and follicular development following letrozole intervention in unexplained infertile patients failed to get pregnant with clomiphene citrate

Samani, Fatemeh Gatreh; Farzadi, Laya; Nezami, Nariman; Tarzamni, Mohammad Kazem; Soleimani, Fatemeh

doi:10.1007/s00404-008-0888-9

Cited by 21 publications

(12 citation statements)

References 37 publications

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“…Studies have shown the efficacy of aromatase inhibitors in ovulation induction in patients who have a poor response to CC (18), in patients with polycystic ovary syndrome who are resistant to CC (19), and in patients with unexplained infertility (20). Regarding the size of the leading follicle, we have found two studies demonstrating larger leading follicles with letrozole compared with CC (21,22), and one study showing no difference between the two (23).…”

mentioning

confidence: 81%

What is the optimal follicular size before triggering ovulation in intrauterine insemination cycles with clomiphene citrate or letrozole? An analysis of 988 cycles

Palatnik

Strawn

Szabó

et al. 2012

Fertility and Sterility

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confidence: 81%

What is the optimal follicular size before triggering ovulation in intrauterine insemination cycles with clomiphene citrate or letrozole? An analysis of 988 cycles

Palatnik

Strawn

Szabó

et al. 2012

Fertility and Sterility

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“…11 In addition, multiple reports suggest that aromatase inhibitors may be effective alternative agents for ovarian stimulation in couples with unexplained infertility. 12–19 Their administration is reported to be associated with monofollicular development in most cases, 3,17 which may result in enhanced fertility and a reduced risk of ovarian hyperstimulation and multiple births, 12,13,20 as compared with current standard therapies such as gonadotropin and clomiphene. Use of an aromatase inhibitor to promote conception has not been associated with a significantly increased risk of congenital anomalies.…”

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confidence: 99%

Letrozole, Gonadotropin, or Clomiphene for Unexplained Infertility

et al. 2015

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BACKGROUND The standard therapy for women with unexplained infertility is gonadotropin or clomiphene citrate. Ovarian stimulation with letrozole has been proposed to reduce multiple gestations while maintaining live birth rates. METHODS We enrolled couples with unexplained infertility in a multicenter, randomized trial. Ovulatory women 18 to 40 years of age with at least one patent fallopian tube were randomly assigned to ovarian stimulation (up to four cycles) with gonadotropin (301 women), clomiphene (300), or letrozole (299). The primary outcome was the rate of multiple gestations among women with clinical pregnancies. RESULTS After treatment with gonadotropin, clomiphene, or letrozole, clinical pregnancies occurred in 35.5%, 28.3%, and 22.4% of cycles, and live birth in 32.2%, 23.3%, and 18.7%, respectively; pregnancy rates with letrozole were significantly lower than the rates with standard therapy (gonadotropin or clomiphene) (P = 0.003) or gonadotropin alone (P<0.001) but not with clomiphene alone (P = 0.10). Among ongoing pregnancies with fetal heart activity, the multiple gestation rate with letrozole (9 of 67 pregnancies, 13%) did not differ significantly from the rate with gonadotropin or clomiphene (42 of 192, 22%; P = 0.15) or clomiphene alone (8 of 85, 9%; P = 0.44) but was lower than the rate with gonadotropin alone (34 of 107, 32%; P = 0.006). All multiple gestations in the clomiphene and letrozole groups were twins, whereas gonadotropin treatment resulted in 24 twin and 10 triplet gestations. There were no significant differences among groups in the frequencies of congenital anomalies or major fetal and neonatal complications. CONCLUSIONS In women with unexplained infertility, ovarian stimulation with letrozole resulted in a significantly lower frequency of multiple gestation but also a lower frequency of live birth, as compared with gonadotropin but not as compared with clomiphene. (Funded by the National Institutes of Health and others; ClinicalTrials.gov number, NCT01044862.)

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“…In premenopausal women, the decrease in oestrogen concentration produces an increase in FSH levels, stimulating consequently a follicular growth. In recent years, many other studies have shown that aromatase inhibitors and, especially, letrozole may be an effective alternative treatment to clomiphene citrate for ovulation induction in women with endometriosis, PCOS, and unexplained infertility [63][64][65][66][67][68][69][70][71][72][73][74][75][76][77]. Over 12 years have passed since the publication of the first study evaluating the use of letrozole for ovulation induction [61,62].…”

Section: Aromatase Inhibitorsmentioning

confidence: 99%

Clinical use of fertility agents and risk of breast cancer

Tomao

Russo

Spinelli

et al. 2014

Current Opinion in Obstetrics &Amp; Gynecology

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Infertility affects many couples in western countries and the use of fertility stimulation techniques is widespread in the last few years, determining personal anxiety, social costs, and organizing difficulties. It is well known that one of the most important causative agents for the development of breast cancer is the proliferative activity of endogenous and exogenous female hormones. Therefore, it seems appropriate to investigate the risk of breast cancer derived from the use of hormonal therapies in infertile women. The final clarification of this question is very important so that all women can realize their dream of having children, with the certainty of not being exposed to an increased risk of breast cancer.

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Endometrial and follicular development following letrozole intervention in unexplained infertile patients failed to get pregnant with clomiphene citrate

Abstract: About 5 mg/day of LET is associated with better follicular phase parameters, endometrial development, serum E2 and LH levels in women with unexplained infertility who failed to get pregnant following frequent CC-treated cycles.

Cited by 21 publications

References 37 publications

What is the optimal follicular size before triggering ovulation in intrauterine insemination cycles with clomiphene citrate or letrozole? An analysis of 988 cycles

What is the optimal follicular size before triggering ovulation in intrauterine insemination cycles with clomiphene citrate or letrozole? An analysis of 988 cycles

Letrozole, Gonadotropin, or Clomiphene for Unexplained Infertility

Clinical use of fertility agents and risk of breast cancer

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