A randomized trial of ovulation induction with two different doses of Letrozole in women with PCOS

Ramezanzadeh, Fatemeh; Nasiri, Roya; Yazdi, Mohammad Sarafraz; Baghrei, Maryam

doi:10.1007/s00404-011-1951-5

Cited by 24 publications

(10 citation statements)

References 30 publications

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“…However, Fozan et al . and Ramezanzadeh et al . have announced decreased endometrial thickness at 7.5 mg letrozole.…”

Section: Discussionmentioning

confidence: 99%

“…8 Meanwhile, Dickey and Holtkamp discovered that in patients stimulated with CC for IUI, no pregnancy was observed when the endometrial thickness was 6 mm on the day of hCG administration, and all preclinical abortions emerged when endometrial thickness was 6-8 mm. 18 However, Fozan et al 17 and Ramezanzadeh et al 32 have announced decreased endometrial thickness at 7.5 mg letrozole. Probably, the higher dose of letrozole leads to greater inhibition of E2 and thus decreases endometrial thickness, which brings about a lower pregnancy rate.…”

Section: Particularly Explained Allocationmentioning

confidence: 99%

See 1 more Smart Citation

Letrozole versus clomiphene citrate for unexplained infertility: A systematic review and meta‐analysis

Liu

Cheng

Lang

et al. 2014

J of Obstet and Gynaecol

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The objective of this study is to investigate and compare the effectiveness of letrozole and clomiphene citrate for improving fertility outcomes, including pregnancy rate, miscarriage rate, multiple pregnancy rate, and incidence rate of adverse events, number of dominant follicles, endometrial thickness at hCG day and serum E2 on hCG day. MEDLINE, EMBASE, CENTRAL, CNKI and CBMdisc databases were searched up to March 2013. Randomized controlled trials comparing letrozole with clomiphene in women with unexplained infertility were included. Pooled relative risk, mean difference and 95% confidence intervals were calculated. We found that there are no differences in pregnancy, miscarriage and multiple pregnancy rates, incidence rate of adverse events, number of dominant follicles (>18 mm) and endometrial thickness at hCG day in women with unexplained infertility between letrozole and clomiphene regimens. The mean (±standard deviation) concentration of serum E2 on hCG day was lower in those treated with letrozole than those with clomiphene. The subgroup of 2.5 mg letrozole displayed a statistically significant higher rate of clinical pregnancy as compared with 100 mg of clomiphene. The results of this study conclude that letrozole is as effective as clomiphene in women with unexplained infertility. Letrozole at a dose of 2.5 mg seems more effective. Further high-quality studies assessing the possible effectiveness of letrozole in selected groups of patients are warranted.

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“…However, Fozan et al . and Ramezanzadeh et al . have announced decreased endometrial thickness at 7.5 mg letrozole.…”

Section: Discussionmentioning

confidence: 99%

Section: Particularly Explained Allocationmentioning

confidence: 99%

Letrozole versus clomiphene citrate for unexplained infertility: A systematic review and meta‐analysis

Liu

Cheng

Lang

et al. 2014

J of Obstet and Gynaecol

View full text Add to dashboard Cite

show abstract

“…This was confirmed by the study of Banerjee Ray et al [21]. Ramenzanzadeh et al found that there was no significant difference in the reproductive outcome when higher daily doses of letrozole were administered [22]. In view of the advantages of letrozole over clomiphene citrate, this drug could be also an adequate option for second choice treatment in clomiphene citrate-resistant patients.…”

Section: Discussionmentioning

confidence: 75%

Algorithm of ovulation induction in patients with polycistic ovary syndrome

Bjelica

Bjelanović²,

Milić

et al. 2016

Med pregl

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As a conclusion of this systematic survey of the efficiency of ovulation induction methods, which confirms and supplements the knowledge in this field, it is possible to form the algorithm for ovulation induction in infertile patients having polycystic ovary syndrome, consisting of the following subsequent steps: 1) modification of life style, 2) induction with clomiphene citrate 3) use of metformin, 4) use ofaromatase inhibitors, 5) application ofgonadotropins and laparoscopic ovarian drilling--as a second-line treatment, and 6) assisted reproductive techniques.

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“…In their study, there was no diVerence regarding days to reach mature follicle between groups. A recent RCT by Ramezanzadeh et al [59] on 67 PCOS patients did not show any advantage to the use of 7.5 mg/day over 5 mg/day dose of letrozole as the Wrst-line treatment for ovulation induction in PCOS women.…”

Section: Third-generation Aromatase Inhibitorsmentioning

confidence: 95%

Clomiphene citrate alternatives for the initial management of polycystic ovary syndrome: an evidence-based approach

Hashim

2012

Arch Gynecol Obstet

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Polycystic ovary syndrome (PCOS) is a prevalent and heterogeneous condition affecting 4-8% of reproductive age women. It is the most common cause of chronic anovulation and is associated with hyperandrogenemia. Clomiphene citrate (CC) is considered as the first-line therapy for ovulation induction in these patients. Despite progress in understanding the pathophysiology of PCOS over the past 20 years, many questions persist to the extent that PCOS was described as "A Riddle Wrapped in a Mystery inside an Enigma". On the other hand, a recent publication from the Centers for Disease Control suggested that CC may be associated with an increased risk of birth defects. The purpose of this review is to critically evaluate and summarize the current literature regarding CC alternatives for the initial management of PCOS focusing specifically on the roles of weight loss and other approaches to ovulation induction as insulin-sensitizing drugs, aromatase inhibitors, minimal stimulation protocol, gonadotrophins and surgery (laparoscopic ovarian drilling). Finally, the efficacy of intrauterine insemination with CC for the initial management of PCOS will be evaluated.

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A randomized trial of ovulation induction with two different doses of Letrozole in women with PCOS

Abstract: The results of this study did not show any advantage to the use of 7.5 mg/day over 5 mg/day dose of Letrozole as the first line treatment for induction of ovulation in women with PCOS.

Cited by 24 publications

References 30 publications

Letrozole versus clomiphene citrate for unexplained infertility: A systematic review and meta‐analysis

Letrozole versus clomiphene citrate for unexplained infertility: A systematic review and meta‐analysis

Algorithm of ovulation induction in patients with polycistic ovary syndrome

Clomiphene citrate alternatives for the initial management of polycystic ovary syndrome: an evidence-based approach

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