Use of an aromatase inhibitor in patients with polycystic ovary syndrome: a prospective randomized trial

Bayar, Ülkü; Başaran, Mustafa; Kıran, Sibel; Coşkun, Ayhan; Gezer, Şener

doi:10.1016/j.fertnstert.2006.04.026

Cited by 84 publications

(72 citation statements)

References 33 publications

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“…This is in good agreement with recent reports which conclude that letrozole has a better ovulation and pregnancy rate as compared to CC in patients with PCOS [22,23]. Several smaller prospective randomized trials have also shown that letrozole may be an acceptable alternative to CC as an ovulation induction drug in women with PCOS [24][25][26]. An ovulation rate of 54.6% and pregnancy rate of 25% with letrozole induction in CC-resistant women with PCOS is reported [2].…”

Section: Discussionsupporting

confidence: 90%

Comparison of letrozole with continuous gonadotropins and clomiphene-gonadotropin combination for ovulation induction in 1387 PCOS women after clomiphene citrate failure: a randomized prospective clinical trial

Ganesh

Goswami

Chattopadhyay

et al. 2009

J Assist Reprod Genet

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Purpose Letrozole, though reported to be an effective ovulation inducing agent, warrants larger randomized trials. The purpose of this study is to compare the efficacy of letrozole with that of rFSH and clomiphene citrate(CC)/rFSH for ovarian stimulation in IUI cycles. Methods Randomized, prospective, single-blinded clinical trial. 1387 PCOS women after CC failure were randomized into three groups: Group A received letrozole, Group B received CC with two doses rFSH and Group C received continuous rFSH day 2 onwards until hCG injection. Results Group A, B and C had an ovulation rate of 79.30%, 56.95% and 89.89% and cycle cancellation rate of 20.70%, 43.05% and 10.11%, respectively. Pregnancy rates in Group A, B and C were 23.39%, 14.35% and 17.92%, while the miscarriage rates were 13.80%, 16.67% and 14.52%, respectively. Conclusion Letrozole appears to be a suitable ovulation inducing agent in PCOS women with CC failure and is found to be most effective when baseline estradiol level >60 pg/ml.

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Section: Discussionsupporting

confidence: 90%

Comparison of letrozole with continuous gonadotropins and clomiphene-gonadotropin combination for ovulation induction in 1387 PCOS women after clomiphene citrate failure: a randomized prospective clinical trial

Ganesh

Goswami

Chattopadhyay

et al. 2009

J Assist Reprod Genet

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“…[16][17][18]. The rate of mature follicular development was significantly higher when letrozole in addition with FSH.…”

Section: Discussionmentioning

confidence: 91%

Use of letrozole versus clomiphene citrate combined with gonadotropins for ovulation induction in infertile women with polycystic ovary syndrome: a pilot study

Athwal¹,

Chakravorty²,

Sur³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONIt is now well known that polycystic ovary syndrome (PCOS) is among the most common endocrine disorders in women of reproductive age, with an estimated prevalence of 5%-10% of the general population, and by far the most common cause of an-ovulatory infertility. 1 Clomiphene citrate has been the most widely used drug for the treatment of infertility.2 However, 20-25% of the women are failing to ovulate due to CC resistant. 3 In such cases, the traditional alternative is to administer gonadotropins; however, it is associated with an enhanced risk of multiple pregnancies and ovarian hyperstimulation. 4 Gonadotropins (FSH/hMG) used in combination with CC decrease the dose required for optimum stimulation and make it more cost-effective in women who fail to react to CC treatment. 5 As of late, aromatase inhibitor has been explored as a potential ABSTRACT Background: The aim of the study was to evaluate the efficacy of letrozole and clomiphene citrate (CC) in gonadotropin-combined for ovulation stimulation in women with polycystic ovary syndrome (PCOS). It was a prospective pilot study. Methods: This prospective trial included 124 patients of infertile women with PCOS. Letrozole dose of 5 mg/day (n = 65) or a CC dose of 100 mg/day (n = 59) was given on day 3 to day 7 of the menstrual cycle, combined with gonadotropin i.e. follicle stimulating hormone (FSH) at a dose 75 IU every day starting on day 7 and continued to day 9. Main outcome measures were occurrence of ovulation, number of mature follicles, serum estradiol (E2) and endometrial thicknesses on the day of human chorionic gonadotropin (hCG), and pregnancy rates. Results: The clinical profile including mean age, duration of infertility, BMI, baseline FSH, LH and E2 of patients belonging to both groups were comparable. The numbers of mature follicles (4.3±0.3 vs. 2.9±0.7) were significantly higher in letrozole+FSH group. Serum E2 levels on the day of hCG (301.78±85.7 vs. 464.7±72.9 pg/mL) were significantly lower in the letrozole+FSH group. Significant differences were found in endometrial thickness measured on the day of hCG in letrozole+FSH group (p=<0.0001). The rate of ovulation was higher in letrozole+FSH group and it was marginally statistically significant (p=0.040). The rate of pregnancy was slightly greater in the letrozole+FSH group (17.85% versus 13.33%), although not statistically significant. Conclusions: Letrozole in combination with FSH appears to be a suitable ovulation inducing agent versus CC with FSH in PCOS. This combination may be more appropriate in patients who are particularly sensitive to gonadotropin.

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“…18 The use of aromatase inhibitors in ovulation induction increased the ovulation and pregnancy rates and these agents appear to have less anti-estrogen effect on the endometrium. 19 LOD is one of the lines of treatments for anovulation due to PCOD. It induces ovulation by decreasing the ovarian theca and thus reducing androgen production.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous ovulation and pregnancy in women with polycystic ovarian disease; a cross sectional study

Sleem

Mohamed

Zakherah

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONPolycystic ovary disease (PCOD) is the most common endocrine disorder in women of reproductive age, with a prevalence of approximately 5-10%. 1 The principal features of PCOD include androgen excess, ovulatory dysfunction, and/or polycystic ovaries. 2PCOD is also associated with insulin resistance (IR), obesity and lipid metabolism disorders, as well as infertility, although these findings have not been addressed in the Rotterdam criteria.3 Recent studies suggest that anovulation resulting from ovarian follicle abnormalities in PCOD patients is 2-fold of normal ovaries.Firstly, early follicular growth is excessive, thus women with PCOD are characterized by an excessive number of small antral follicles. Secondly, the selection of one follicle and its further maturation to a dominant follicle does not occur. This abnormality in the folliculogenesis leads to menstrual dysfunction presented as oligomenorrhea or amenorrhea. 4 A related mechanism of ABSTRACT Background: Polycystic ovary disease (PCOD) is the most common endocrine disorder in women of reproductive age, with a prevalence of approximately 5-10%. This study aims to assess the rate of spontaneous ovulation and pregnancy in patients. The present study was a cross sectional study conducted at Woman's Health Hospital, Assiut University, Assiut, Egypt. Methods:The current study was a cross sectional study carried out in Assiut Women's Health Hospital between the 1 st October 2016 and 31 st July 2017. The patients were selected as infertile patients with PCOD. The patient ages range between 20 and 35 years. The BMI is between 18 and 30 Kg/m 2 . The main outcome measure was the rate of spontaneous ovulation and spontaneous pregnancy in the 3 cycles. Results: The mean age of the study participants was 26.64±4.59 years and the mean BMI was 24.46±2.62Kg/m 2 . The sonographic ovarian volume was 12.47±0.69 mm 3 for the right ovary and 12.74±0.73 mm 3 for the left ovary. No difference in the serum FSH, LH, FSH/LH ratio and prolactin over the 3 consecutive cycles. The rate of spontaneous ovulation in the 3 cycles was 6 women (8.6%) and 2 cases (2.8%) became pregnant spontaneously during the study period. There is no statistical significant difference between ovulating and non-ovulating women according to the BMI and ovarian volume. Conclusions: The present study concluded that the rate of spontaneous ovulation was 8.6% in women with PCOD within 3 cycles with no adverse effects of drugs or surgical interference.

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Use of an aromatase inhibitor in patients with polycystic ovary syndrome: a prospective randomized trial

Cited by 84 publications

References 33 publications

Comparison of letrozole with continuous gonadotropins and clomiphene-gonadotropin combination for ovulation induction in 1387 PCOS women after clomiphene citrate failure: a randomized prospective clinical trial

Comparison of letrozole with continuous gonadotropins and clomiphene-gonadotropin combination for ovulation induction in 1387 PCOS women after clomiphene citrate failure: a randomized prospective clinical trial

Use of letrozole versus clomiphene citrate combined with gonadotropins for ovulation induction in infertile women with polycystic ovary syndrome: a pilot study

Spontaneous ovulation and pregnancy in women with polycystic ovarian disease; a cross sectional study

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