The effects of letrozole on women with endometriosis undergoing ovarian stimulation for <i>in vitro</i> fertilization

Kim, Se Jeong; Choo, Chang Woo; Kim, Seul Ki; Lee, Jung Ryeol; Jee, Byung Chul; Suh, Chang Suk; Lee, Won Don; Kim, Seok Hyun

doi:10.1080/09513590.2019.1650338

Cited by 13 publications

(3 citation statements)

References 27 publications

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“…There is an ongoing randomized trial of letrozole-gonadotropins versus gonadotropin alone during ovarian stimulation for infertility (NCT02912988), which is expected to provide more robust data about the use of concomitant letrozole (or not) during ovarian stimulation for infertility. Lastly, there may be non-oncologic circumstances in which one might infer a possible clinical benefit of lower estrogen levels, such as in the setting of endometriosis or a history of provoked thromboembolism [21].…”

Section: Discussionmentioning

confidence: 99%

Concomitant tamoxifen or letrozole for optimal oocyte yield during fertility preservation for breast cancer: the TAmoxifen or Letrozole in Estrogen Sensitive tumors (TALES) randomized clinical trial

Letourneau

Juarez‐Hernandez

Wald

et al. 2021

J Assist Reprod Genet

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Purpose To determine whether concomitant tamoxifen 20 mg with gonadotropins (tamoxifen-gonadotropin) versus letrozole 5 mg with gonadotropins (letrozole-gonadotropin) affects mature oocyte yield. Methods Open-label, single-institution, randomized trial. Inclusion criteria included the following: females, ages 18-44 years old, with new diagnosis of non-metastatic breast cancer, who were undergoing fertility preservation with either oocyte or embryo cryopreservation. Those with estrogen-receptor-positive (ER+) breast cancer were randomized to tamoxifen-gonadotropin or letrozole-gonadotropin. Another group with estrogen-receptor-negative (ER−) breast cancer was recruited, as a prospectively collected comparison arm who took neither letrozole nor tamoxifen (gonadotropin only). The primary outcome was the number of mature oocytes obtained from the cycle. The randomized groups were powered to detect a difference of three or more mature oocytes. Results Forty-five patients were randomized to tamoxifen-gonadotropin and fifty-one to letrozole-gonadotropin. Thirty-eight patients completed gonadotropin only. Age, antral follicle count, and body mass index were similar between the randomized groups. Our primary outcome of mature oocyte yield was similar between the tamoxifen-gonadotropin and letrozolegonadotropin groups (12±8.6 vs. 11.6±7.5, p=0.81, 95%CI of difference =−2.9 to 3.7). In a pre-specified secondary comparison, mature oocyte yield was also similar with tamoxifen-gonadotropin or letrozole-gonadotropin versus gonadotropin only (12±8.6 vs. 11.6±7.5 vs. 12.4±7.2). There were no serious adverse events in any of the groups. Conclusions Tamoxifen-gonadotropin and letrozole-gonadotropin produced a similar number of mature oocytes. Women who received either tamoxifen-gonadotropin or letrozole-gonadotropin had a similar number of oocytes to the gonadotropin-only group. Trial registration NCT03011684 (retrospectively registered 1/5/2017, after 9% enrolled)

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Section: Discussionmentioning

confidence: 99%

Concomitant tamoxifen or letrozole for optimal oocyte yield during fertility preservation for breast cancer: the TAmoxifen or Letrozole in Estrogen Sensitive tumors (TALES) randomized clinical trial

Letourneau

Juarez‐Hernandez

Wald

et al. 2021

J Assist Reprod Genet

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“…The effect of gonadotrophin-releasing hormone (GnRH) agonists on oocyte and embryo quality in women endometriosis has been investigated in a small number of studies. A retrospective cohort study comparing the administration of GnRH agonist alone or combined with the aromatase inhibitor letrozole prior to IVF in patients with endometriosis found no significant difference between groups in the number of oocytes, embryos and fertilization rates, though the mean percentage of mature oocytes was higher in the group treated with GnRH agonist alone (Kim et al, 2020). In contrast, in a similar study another research group observed a significantly higher number of oocytes, clinical pregnancy rate and live birth rate in patients with endometriosis treated with the combination of GnRH agonist and letrozole compared to patients treated with GnRH agonist alone (Cantor et al, 2019).…”

Section: Management Optionsmentioning

confidence: 99%

“…Treatment with dienogest and the GnRH agonist triptorelin in patients after laparoscopic surgery and before ovarian stimulation in IVF cycles resulted in a significantly higher number of oocytes retrieved and good-quality embryos compared to women receiving no treatment (Muller et al, 2017). Several research groups have found no significant impact of dienogest on oocyte quality or fertilization rates in women with endometriosis undergoing IVF (Kim et al, 2017, Barra et al, 2020. Barra and colleagues compared IVF outcomes in patients with endometriosis with and without pre-treatment with dienogest for 3 months.…”

Section: Management Optionsmentioning

confidence: 99%

Endometriosis, Oocyte and Embryo Quality

Latif¹,

Sarıdoğan²

2023

Preprint

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Endometriosis is a common finding among women with infertility and women who are diag-nosed with endometriosis are almost twice as likely to experience infertility. Mechanisms by which endometriosis causes infertility remain poorly understood. In this review we evaluate the current literature on the impact of endometriosis on oocyte and embryo quality. The presence of endometriosis evidently reduces ovarian reserve, oocyte quality and embryo quality, however this does not appear to translate to a clear clinical impact. Analysis of data from large assisted reproduction technology registries has shown that women with endometriosis have a lower oo-cyte yield but no reduction in reproductive outcomes. There is a need for future studies in the form of well-designed randomised controlled trials to further evaluate the role of surgical and medi-cal treatment options in women with endometriosis undergoing assisted conception.

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