Clomiphene citrate and letrozole to reduce follicle‐stimulating hormone consumption during ovarian stimulation: systematic review and meta‐analysis

Bechtejew, Tatiana Nascimbem; Nadai, Mariane Nunes de; Nastri, C.O.; Martins, Wellington P.

doi:10.1002/uog.17442

Cited by 38 publications

(22 citation statements)

References 53 publications

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“…Decrement of estrogen levels results in increment of androgen levels. This microenvironment induces endogenous gonadotropin secretion and, according to this result, letrozole is being used for ovulation induction especially in POR [32]. Researchers reported improved cycle outcomes in gonadotropin dose decrement with letrozole combination compared to high-dose gonadotropin administration for POR [33].…”

Section: Aromatase Inhibitorsmentioning

confidence: 99%

Ovarian stimulation modalities in poor responders

Özkan

2019

Turk J Med Sci

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In a group of IVF/ICSI cycles, despite the appropriate ovarian stimulation, the number of oocytes collected is below the expected value. This condition is defined as poor ovarian response (POR) to stimulation. POR brings the risk of cycle cancellation with an estimated rate of 20%. Infertility experts are trying to improve cycle outcomes of POR cases with multiple modifications. This review article will present the latest modifications on the management of POR. The studies performed for improving cycle outcome in POR cases were evaluated and their notable results were presented. The first intervention among infertility specialists is to make a standard definition for POR. The BOLOGNA criteria and the subsequent POSEIDON group definitions are the latest updates in POR management. GnRH antagonists, estradiol priming, double stimulation, letrozole administration, DHEA, and herbal therapy supplementations are the recent modifications done to improve oocyte retrieval and subsequent embryo transfer for POR cases. This review article presents the encouraging methods applied for POR cases to improve cycle outcome.

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Section: Aromatase Inhibitorsmentioning

confidence: 99%

Ovarian stimulation modalities in poor responders

Özkan

2019

Turk J Med Sci

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“…The objective is to increase in a limited way the number of growing follicles. The treatment by FSH is indicated in case of failure with stimulation by clomiphene citrate or in case of resistance, when there is no conception despite ovulatory cycles and when there is an absence of ovulation despite normal dosages [4].…”

Section: Discussion:-mentioning

confidence: 99%

Non-in Vitro Fertilization Induction of Ovulation Experience.

Zhiri¹,

AnnacirZhiri²,

Hamdouch³

2019

IJAR

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Infertility has always been a preoccupation in a couple's life. To tackle this infertility, a therapeutic arsenal is available but can be expensive. In Morocco, the lack of coverage by infertility health insurances can lead to a late care for the couples who need it. The objective of this work is to present a non-in vitro fertilization (non-IVF) stimulation method, which is more affordable. However, this technique is only possible when sperm parameters, the biological checkup and the tubular permeability allow it. This is a retrospective study on infertile couples gathered into two Assisted Human Reproduction private practices, from January 2007 to January 2017. The protocol we have been using includes clomiphene citrate and FSH. 998 couples analyses have been compiled. 2674 cycles of non-IVF induction of ovulation were undergone. The presence of one or several follicles was noticed in 2450 cycles. This has led to 598 pregnancies, 18 of which are twin pregnancies. Our results, which stay stable, reassure us into keeping up the use of this protocol.

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“…The starting dose of Gn in the CC cohort was intentionally lowered by 25–30% of the standard dose for that age, BMI and AMH, presuming that both CC and FSH would have synergistic action on ovarian folliculogenesis. A recent systematic review studying whether CC could be used for reducing FSH consumption without affecting results found that, when compared to long agonist regimes, the mean FSH reduction was by 18.9 ampoules (95% CI = −23.7 to −14.2; seven studies, n = 1939, I2 = 99) in the nonpoor responder category; however, the OCR reduced by 4–5 times. (RR = −4.6; 95% CI = −6.1 to −3.0; eight studies; n = 1631).…”

Section: Discussionmentioning

confidence: 99%