Impact of letrozole on ultrasonographic markers of endometrial receptivity in polycystic ovary syndrome women with poor endometrial response to clomiphene citrate despite adequate ovulation

Morad, Ahmed; Farag, Mohamed A.

doi:10.1016/j.mefs.2014.08.004

Cited by 7 publications

(6 citation statements)

References 20 publications

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“…This observation was in line with many previous studies. Morad et al concluded from a research on 60 infertile women with PCOS that the letrozole compared to clomiphene citrate has a better therapeutic effect on the arteries of the uterus 12 Similar results were achieved by Mohamed Selim et al in 2012. 8 Based on Sakhavar et al investigation, letrozole and clomiphene citrate have no significant effect on the RI and PI in women with unexplained infertility.…”

Section: Discussionmentioning

confidence: 53%

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The combination of letrozole and metformin has a better therapeutic effect on uterine and ovarian arteries in PCOS patients

Farshchian¹,

Nezhad²,

Kamangar³

2018

AMJ

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BackgroundPolycystic ovary syndrome (PCOS) is the most prevalence endocrine disorder in the reproductive age of women. In these patients, medications such as clomiphene citrate, letrozole and metformin are used to induce ovulation and overcome infertility. AimsThis study was done for comparing the findings of Color Doppler sonography of the uterine and ovarian arteries in women with PCOS under treatment of two drug groups of letrozole-metformin and clomiphene-metformin. MethodsIntervention-applied study was performed on 108 women with secondary infertility due to PCOS in Imam Reza Hospital of Kermanshah in 2016. Women were divided in two groups of 54 people, for investigating the effect of letrozole-metformin and clomiphene-metformin on ovarian and uterine arteries. ResultsBlood flow in the uterus and ovaries significantly increased after treatment with letrozole-metformin and clomiphenemetformin (P<0.05). However, the effect of letrozolemetformin was significantly higher than that of clomiphenemetformin on uterine and ovarian arteries Resistance Index (RI) (P<0.05). ConclusionLetrozole-metformin as well as clomiphene-metformin have a significant effect on blood flow in the uterus and ovaries. The group which received letrozole-metformin had a better response in this regard. Key WordsInfertility, Resistance Index (RI), Polycystic Ovary Syndrome (PCOS) What this study adds:1. What is known about this subject? PCOD is one of the most common fertility disorders in women of reproductive age with several treatment methods. What new information is offered in this study?The reduction of RI in the uterine and ovarian arteries was greater in letrozole-metformin group compared to clomiphene citrate-metformin. Treatment with letrozolemetformin is recommended. What are the implications for research, policy, or practice?Since polycystic ovary can cause infertility, treatment or control of this disease can help infertile couples in fertility.

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Section: Discussionmentioning

confidence: 53%

“…Letrozole even enhances uterine receptivity by increasing the endometrial thickness, trilaminar and blood flow. 12 But these drugs have side effects on the patient. For example, clomiphene citrate causes massive enlargement of the ovaries metformin causes hypoglycaemia and diarrhoea and letrozole can also lead to thromboembolism.…”

Section: Researchmentioning

confidence: 99%

The combination of letrozole and metformin has a better therapeutic effect on uterine and ovarian arteries in PCOS patients

Farshchian¹,

Nezhad²,

Kamangar³

2018

AMJ

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“…Endometrial pinopodes are inhibited or eliminated by CC, which hampers embryo development. 11 Furthermore, as CC blocks ER activity, the tolerable estrogen level of the endometrium is lowered and the receptive state window opening time of the uterus is prolonged during CC + HMG treatment, neither of which is conducive for embryo implantation. One of the key factors affecting endometrial receptivity is the dose of HMG, and a relatively high dose of HMG in an estrogen state causes the uterus to convert to a nonreceptive state more quickly, making implantation difficult or even impossible in some cases.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Three Ovulation Induction Therapies for Patients With Polycystic Ovary Syndrome and Infertility

Xia

Zeng

Qingmei

2023

The Journal of Clinical Pharma

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The purpose of this research was to evaluate the efficacy of 3 ovulation induction therapies for treating infertility in patients with polycystic ovary syndrome (PCOS). In this retrospective study, we compared the success rates of 90 patients who underwent intrauterine insemination, who were randomly assigned to 1 of 3 treatment groups: letrozole (LE) + urinary gonadotropin (human menopausal gonadotropin [HMG]), clomiphene (CC) + HMG, or HMG alone. Using ultrasound scanning, we examined the number of mature follicles, ovulation rate, clinical pregnancy rate, endometrial thickness, and blood flow. When compared to the other 2 groups, the LE + HMG group had significantly higher levels of mature follicles, ovulation rate, clinical pregnancy rate, estradiol, and luteinizing hormone on the day of the human chorionic gonadotropin injection and endometrial receptivity (P < .05). There was no statistically significant difference between the 3 groups in terms of abortion rate, ectopic pregnancy rate, or adverse reactions. In this research, we found that infertility in patients with PCOS could be effectively treated by combining LE with HMG. This protocol increased ovulation, boosted fertility, and enhanced endometrial receptivity with no increase in adverse reactions. Therefore, it may be a useful clinical approach for inducing ovulation and treating infertility in patients with PCOS.

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“…Several studies revealed that CC reduces endometrial receptivity, as it impairs endometrial development and uterine blood flow, resulting in endometrial thinning in 15-50 % of patients with subsequent implantation failure and induces early pregnancy loss due to luteal phase defect [14]. Raslan, Walid, and Elkatan found poor endometrial thickness, trilaminar pattern, and endometrial blood flow in clomiphene cycles due to its antiestrogenic effect [7,15,16]. Seddigeh and Mehbobeh (2006) identified a statistically significant difference in the mean endometrial thicknesses between cycles that resulted in pregnancy and those that did not [17].…”

Section: Discussionmentioning

confidence: 99%

Gonadotropin Alone is a Better Drug for Ovarian Stimulation than in Combination with Clomiphene in Intrauterine Insemination

Sinha

Agrawal

2015

J Obstet Gynecol India

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Impact of letrozole on ultrasonographic markers of endometrial receptivity in polycystic ovary syndrome women with poor endometrial response to clomiphene citrate despite adequate ovulation

Cited by 7 publications

References 20 publications

The combination of letrozole and metformin has a better therapeutic effect on uterine and ovarian arteries in PCOS patients

The combination of letrozole and metformin has a better therapeutic effect on uterine and ovarian arteries in PCOS patients

Comparison of Three Ovulation Induction Therapies for Patients With Polycystic Ovary Syndrome and Infertility

Gonadotropin Alone is a Better Drug for Ovarian Stimulation than in Combination with Clomiphene in Intrauterine Insemination

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