Letrozole as an adjunct in GnRH antagonist cycles improves IVF outcome in poor responders

Sekhon, L.; Lee, J.A.; Whitehouse, M.C.; Copperman, A.B.; Grunfeld, L.

doi:10.1016/j.fertnstert.2014.07.751

Cited by 3 publications

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“…They found a decline in gonadotropin requirement and the trend toward improvement in implantation and ongoing pregnancy rates in letrozole added group (30). In Goswami and colleagues study, long GnRH- agonist stimulation protocol with high dose gonadotropin (330-450 IU/day) was compared with a letrozole/low-dose gonadotropin (75 IU/day) combination regimen in poor responders.…”

Section: Discussionmentioning

confidence: 97%

“…The limitations related to the methodological drawbacks (small study population , lack of randomization, and the different mean age of patients in the compared groups), retrospective nature, and lack of uniform definition for “poor ovarian response”, do not allow to compare the results of these trials and identify firm conclusion (13, 30, 32, 33). …”

Section: Discussionmentioning

confidence: 99%

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Letrozole+ GnRH antagonist stimulation protocol in poor ovarian responders undergoing intracytoplasmic sperm injection cycles: An RCT

Ebrahimi

Akbari-Asbagh

Ghalandar-Attar

2017

IJRM

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Background:Gonadotropin-releasing hormone (GnRH) antagonist protocol has been proposed as a potentially proper option for the patients with limited ovarian reserve. Nevertheless, there is no significant difference in terms of clinical pregnancy between the GnRH antagonist and agonist cycles. The use of aromatase inhibitors such as letrozole was suggested by some studies. Objective:The object of this study was to evaluate the efficacy of letrozole co-treatment with GnRH-antagonist protocol in ovarian stimulation of poor responder patients undergoing intracytoplasmic sperm injection.Materials and Methods:A double-blinded randomized control trial was conducted on 70 infertile women with poor ovarian response based on Bologna criteria in two groups: letrozole+GnRH-antagonist (LA) group and placebo+GnRH-antagonist (PA) group (n=35/each). The LA group involved at letrozole 2.5 mg daily over 5 days and recombinant human follicle stimulating hormone 225 IU/daily. The PA group received placebo over 5 days and recombinant human follicle stimulating hormone at the same starting day and dose, similar to LA group. GnRH-antagonist was introduced once one or more follicle reached ≥14 mm. The main outcome measures were the number of oocytes retrieved, fertilization rate, implantation rate, cycle cancellation rate, and clinical pregnancy rate.Results:There were no significant differences in demographic characteristics between groups. There were no significant differences between groups regarding the number of oocytes retrieved (p=0.81), number of embryos transferred (p=0.82), fertilization rate (p=0.225), implantation rate (p=0.72), total cycle cancelation rate (p=0.08), and clinical pregnancy rate (p=0.12). Conclusion:The use of letrozole in GnRH-antagonist cycles does not improve clinical outcomes in poor responder patients undergoing intracytoplasmic sperm injection.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Letrozole+ GnRH antagonist stimulation protocol in poor ovarian responders undergoing intracytoplasmic sperm injection cycles: An RCT

Ebrahimi

Akbari-Asbagh

Ghalandar-Attar

2017

IJRM

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“…Literatürde letrazolün adjuvan olarak kullanıldığı ve klinik sonuçların farklılık gösterdiği az sayıda çalışma mevcuttur. Olumlu sonuçlar veren çalışmaların sonuçları dikkatle ele alınmalıdır 23 . Kontrollü ovaryan stimülasyon sikluslarının hedefinin devam eden gebelik ve canlı doğum olduğu düşünülür ise, toplanan oosit sayısının artmış olmasının canlı doğumu arttırmadığı taktirde başarıyı arttırdığı yönünde yorumlamak doğru bir yaklaşım değildir.…”

Section: Gereç Ve Yöntemunclassified

Effects of GnRH Antagonist/Letrozole Stimulation Protocol on Outcomes of Intracytoplasmic Sperm Injection Cycles in Poor Ovarian Responders

Kasapoğlu

Türk

Cakir

et al. 2018

Uludağ Üniversitesi Tıp Fakültesi Dergisi

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Bu retrospektif çalışmada daha önce düşük ovaryan rezerv (DOR) endikasyonu ile intrasitoplazmik sperm enjeksiyonu (ICSI) siklusu yapılması amacı ile antagonist protokoller ile kontrollü ovaryan hiperstimülasyon (KOH) uygulanmış ve canlı doğum elde edilemeyen hastalarda, takip eden stimülasyon siklusunda antagonist protokole aromataz inhibitörü olan letrozol eklenmesinin siklus sonuçlarına etkisi önceki tedavi siklusları ile karşılaştırılarak değerlendirilmesi hedeflenmiştir. Çalışmaya Haziran 2013-Aralık 2015 yılları arasında ICSI için KOH uygulanan 26 hasta dahil edildi. Elektronik veri tabanı kullanılarak, DOR endikasyonu ile ICSI uygulanmış olan 26 hastanın KOH protokolü karaktarestikleri belirlendi. Önceki KOH siklusları sonrası embriyo transferi yapılarak canlı doğum elde edilemeyen 26 hastaya takip eden tedavi sikluslarında erken folliküler fazda konvansiyonel antagonist stimülasyon protokolüne letrozol eklendiğinde önceki KOH siklusları ile karşılaştırıldığında; kullanılan total gonadotropin dozu anlamlı olarak düşerken (p= 0.035), elde edilen oosit, matür oosit, döllenme oranı, elde edilen embriyo sayısı, transfer edilen embriyo sayıları, dondurulan embriyo sayıları ve klinik gebelik oranların anlamlı farklılık göstermediği tespit edildi. Anahtar Kelimeler: Letrozol. Düşük over rezervi. Intrasitoplazmik sperm enjeksiyonu. GnRH antagonist.

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Effectiveness of recombinant luteinizing hormone/human menopausal gonadotropin/letrozole as additives to recombinant follicle-stimulating hormone in women with poor ovarian reserve undergoing controlled ovarian stimulation for in vitro fertilization/intracytoplasmic sperm injection

et al. 2021

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Letrozole as an adjunct in GnRH antagonist cycles improves IVF outcome in poor responders

Cited by 3 publications

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Letrozole+ GnRH antagonist stimulation protocol in poor ovarian responders undergoing intracytoplasmic sperm injection cycles: An RCT

Letrozole+ GnRH antagonist stimulation protocol in poor ovarian responders undergoing intracytoplasmic sperm injection cycles: An RCT

Effects of GnRH Antagonist/Letrozole Stimulation Protocol on Outcomes of Intracytoplasmic Sperm Injection Cycles in Poor Ovarian Responders

Effectiveness of recombinant luteinizing hormone/human menopausal gonadotropin/letrozole as additives to recombinant follicle-stimulating hormone in women with poor ovarian reserve undergoing controlled ovarian stimulation for in vitro fertilization/intracytoplasmic sperm injection

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