The role of Letrozole (LE) in controlled ovarian stimulation (COS) in patients at high risk to develop ovarian hyper stimulation syndrome (OHSS). A prospective randomized controlled pilot study

Tshzmachyan, Ruzanna; Hambartsoumian, Eduard

doi:10.1016/j.jogoh.2019.101643

Cited by 23 publications

(17 citation statements)

References 41 publications

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“…OHSS is a potentially life-threatening complication of ovarian stimulation during the practice of assisted reproductive technologies (ART). In the rat OHSS model, letrozole decreases the level of VEGF, increases the level of PEDF ( 56), the combined results should lead to a decrease in the incidence of OHSS (57).…”

Section: Letrozole In the Prevention And Treatment Of Ovarian Hyperstimulation Syndromementioning

confidence: 99%

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Letrozole for Female Infertility

et al. 2021

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Letrozole, an aromatase inhibitor that blocks estrogen synthesis by inhibiting the final step of the estrogen biosynthetic pathway, has been used in the applications of a wide range of infertility settings. It has been more than 20 years since the initial clinical trial of letrozole for ovulation induction. In light of the accumulating clinical and basic evidence, the efficacy and safety of letrozole have been identified. This mini review focuses on our current knowledge of the applications and mechanisms of letrozole for female infertility and various questions are put forward about how letrozole could be more effectively used.

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Section: Letrozole In the Prevention And Treatment Of Ovarian Hyperstimulation Syndromementioning

confidence: 99%

“…A prospective randomized controlled pilot study showed that in PCOS patients with extremely high Anti-Mullerian Hormone (AMH) levels, co-administration with letrozole results in reduced incidence of OHSS ( 58 ). However, study from Wang et al.…”

Section: Letrozole In the Prevention And Treatment Of Ovarian Hyperstimulation Syndromementioning

confidence: 99%

Letrozole for Female Infertility

et al. 2021

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“…Compared with standard GnRHagonist protocol, it related to lower OHSS rate, but had higher cycle cancellation rate. CLBR after repeated ovulation was not affected, and was mostly used for the decline of ovarian function [22][23][24]. In summary, the Prolonged GnRH-agonist protocol improves the CLBR of single oocyte collection in PCOS patients, and is the recommended scheme for IVF treatment in PCOS patients.…”

Section: Discussionmentioning

confidence: 98%

The key factors affecting cumulative live birth rate after single oocyte retrieved in women during IVF/ICSI-ET: a retrospective analysis of 1380 PCOS patients

Xia

Tan

et al. 2021

Preprint

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Background: The factors affecting the cumulative live birth rate (CLBR) of PCOS patients who received in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) are unknown.Methods: Here we carried out a retrospective analysis of 1380 PCOS patients who received IVF/ICSI-ET for the first time from January 2014 to December 2016. According to the cumulative live births of PCOS patients after single oocyte collection, they were divided into cumulative live births group (group A) and non-cumulative live births group (group B).Results: The conservative cumulative live birth rate was 63.48%. There were 876 cumulative live births (group A) and 504 non-cumulative live births (group B) according to whether the patients had live births or not. Competition analysis showed that duration of infertility, primary/secondary type of infertility, stimulation protocols, starting dose of gonadotrophins and oocyte retrieved numbers were significantly correlated with CLBR. The Cox proportional risk regression model of PCOS patients showed that stimulation protocols had a significant impact on CLBR. Patients in the GnRH-antagonist protocol group and the mild stimulation protocol had lower CLBR than those in the Prolonged GnRH-agonist protocol, which was statistically significant. PCOS patients with the starting dose of gonadotrophins greater than 112.5u had lower CLBR than those with less than 100u, which was statistically significant. Women with 11-15 oocytes and 16-20 oocytes had higher CLBR than women with 1-9 oocytes, which was statistically significant.Conclusions: According to our statistical results, patients with PCOS represent a challenge for reproductive medicine.

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“…AMH level might affect the function of letrozole, reducing the risk of OHSS. It has been found that for those women with PCOS with AMH level >50 pmol/L, the rate of moderate and mild OHSS in the LE group decreased to five times lower than those without letrozole treatment (24).…”

Section: Discussionmentioning

confidence: 99%

Prednisone combined with letrozole reduced risk of ovarian hyperstimulation syndrome (OHSS) in women undergoing long-term gonadotropin-releasing hormone analog treatment

Fang¹,

Ruan²,

Yang³

et al. 2021

Ann Palliat Med

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Background: Ovarian hyperstimulation syndrome (OHSS) is a severe disease that can lead to serious complication. Letrozole has been applied during controlled ovarian hyperstimulation (COH) to reduce the rate of OHSS in women undergoing long-term Gonadotropin-releasing Hormone Analog (GnRHa) treatment for assisted fertility. Prednisone can prevent vasodilatation and increased vascular permeability, which is common during OHSS. However, few studies have evaluated the combined effect of letrozole and prednisone in preventing severe OHSS and is the aim of our retrospective study of patients receiving GnRHa treatment.Methods: A total of 296 women who accepted autologous in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatments were included in this retrospective study. There were three groups: 146 women had letrozole, including letrozole alone (LE group, n=60) and letrozole with prednisone (LE + Pre group, n=86), and 150 women had no treatment (C group). Severe OHSS was diagnosed according to clinical evidence of hydrothorax, severe dyspnea, oliguria/anuria, and intractable nausea/vomiting.Results: The addition of prednisone to letrozole successfully reduced the occurrence rate of severe OHSS than those women administered letrozole alone (55.0% vs. 70.6%, P=0.022). However, the ongoing pregnancy rate was lower in the LE + Pre group than that in the LE-alone group (64.3% vs. 87.0%, P=0.025). Surprisingly, progesterone level on the trigger day (>0.895 ng/mL) is a strong predictor for pregnancy failure with a specificity of 68.3% and sensitivity of 65.7% in the LE-alone group.Conclusions: Treatment with a combination of letrozole and prednisone may lower the rate of severe OHSS in women with prolonged gonadotropin-releasing hormone agonist protocol during assisted fertility treatment. When the progesterone level on trigger day is over 0.895 ng/mL, letrozole treatment may negatively affect clinical pregnancy.

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The role of Letrozole (LE) in controlled ovarian stimulation (COS) in patients at high risk to develop ovarian hyper stimulation syndrome (OHSS). A prospective randomized controlled pilot study

Cited by 23 publications

References 41 publications

Letrozole for Female Infertility

Letrozole for Female Infertility

The key factors affecting cumulative live birth rate after single oocyte retrieved in women during IVF/ICSI-ET: a retrospective analysis of 1380 PCOS patients

Prednisone combined with letrozole reduced risk of ovarian hyperstimulation syndrome (OHSS) in women undergoing long-term gonadotropin-releasing hormone analog treatment

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