Clomiphene citrate versus letrozole: molecular analysis of the endometrium in women with polycystic ovary syndrome

Wallace, Kedra; Johnson, Venessia; Sopelak, Victoria M.; Hines, Randall S.

doi:10.1016/j.fertnstert.2011.07.1092

Cited by 39 publications

(19 citation statements)

References 37 publications

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“…However, in the latter study, DKK‐1 levels reduced after 24 months of treatment with anastrozole . This is in contrast to the study on letrozole where it increased mRNA expression of DKK1 in the endometrium of women with polycystic ovary syndrome . The discrepancies observed in these studies could be related to the drugs used, treatment duration and estimation in either serum or endometrium as reported in these studies.…”

Section: Discussioncontrasting

confidence: 69%

Differential profile of letrozole and exemestane on bone turnover markers in vinylcyclohexene diepoxide treated ovotoxic female mice

Kalam

Talegaonkar

Vohora

2016

Fundamemntal Clinical Pharma

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The third generation aromatase inhibitors are currently the drugs of choice for treatment of early and advanced breast cancer in postmenopausal women. One of the significant limiting factor during therapy is their negative impact on bone health. In the present study, we compared the effects of a non-steroidal (letrozole) and a steroidal aromatase inhibitor (exemestane) on bone mineral density and markers of bone turnover including alkaline phosphatase (ALP), tartrateresistant acid phosphatase (TRAP), hydroxyproline (HxP), receptor activator of nuclear factor kappa-B ligand (RANKL), sclerostin and dickkopf-1 (DKK-1) in vinlycyclohexene di epoxide (VCD)-induced ovotoxic female mice. VCD administration for 15 days mimicked a postmenopausal state with reduced serum estradiol levels. Ovotoxicity was accompanied by reduced ALP, HxP and enhanced TRAP, sclerostin and DKK-1 activity in femoral epiphysis and lumbar vertebrae of mice. While letrozole (1mg/kg) administration for one month enhanced bone turnover in ovotoxic mice, exemestane (3.25 mg/kg) was devoid of such effects in both normal and ovotoxic mice. The latter, however, reduced ALP in femoral epiphysis of ovotoxic mice.Letrozole depleted estradiol levels in ovotoxic mice and enhanced RANKL activity while exemestane neither affected estradiol nor RANKL in both normal and ovotoxic mice, and enhanced sclerostin and DKK-1 in femoral epiphysis only. The study indicates that the two aromatase inhibitors possesses differential profile in terms of their effects on bone and that exemestane could be a better option for the treatment of breast cancer in postmenopausal women at least in terms of its effects on bone.

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Section: Discussioncontrasting

confidence: 69%

Differential profile of letrozole and exemestane on bone turnover markers in vinylcyclohexene diepoxide treated ovotoxic female mice

Kalam

Talegaonkar

Vohora

2016

Fundamemntal Clinical Pharma

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“…Letrozole is a third-generation aromatase inhibitor drug without antagonistic effects on the estrogen receptors and it induces mono-follicular development due to maintenance the normal central feedback [15]. Furthermore, a pilot study focusing on comparing letrozole and clomiphene citrate for ovulation induction in PCOS women concluded that letrozole positively influences several markers of endometrial receptivity compared with clomiphene citrate [16]. Recently, Zhang et al performed a retrospective study in patients with PCOS undergoing FET and reported that letrozole administration for endometrial preparation was associated with higher live birth rates compared with artificial cycles after statistical adjustment for confounding factors; therefore, future prospective randomized studies are required to verify these findings [2].…”

Section: Introductionmentioning

confidence: 99%

The effect of letrozole versus artificial hormonal endometrial preparation on pregnancy outcome after frozen-thawed embryos transfer cycles: a randomized clinical trial

Najarkolaei

Moini

Kashani

et al. 2020

Reprod Biol Endocrinol

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Background Considering that clinical trial studies are limited in polycystic ovary syndrome (PCOS) patients, and there is no consensus on an optimum endometrial preparation protocol for frozen embryo transfer (FET), the present study was designed as a randomized clinical trial to compare the reproductive outcomes following stimulated cycles with letrozole plus human menopausal gonadotropin (HMG) for endometrial preparation compared with routine AC-FET. Methods This randomized controlled trial was carried out on infertile PCOS patients who underwent IVF/ICSI and FET cycles in Arash Women’s Hospital affiliated to Tehran University of Medical Sciences between September 2018 and January 2020. PCOS diagnosis was based on the Rotterdam criteria. Eligible patients were randomly allocated into two groups: stimulated cycle with letrozole plus (HMG) (intervention group) and routine artificial hormonal endometrial preparation (control group). Results One hundred seventy-seven infertile patients were recruited for participation in the study. Of these, 57 women were excluded due to non-eligibility for entering the study, and a total of 120 patients were randomly assigned to two study groups. After follow up, the cycle outcomes of 57 patients in the intervention group and 59 patients in the control group were compared. The data analysis showed that the two groups did not have significant differences in fundamental and demographic characteristics. After the intervention, there were no significant differences in implantation rate, chemical, ectopic, and clinical pregnancy rates between groups. Moreover, the rates of miscarriage and ongoing pregnancy were similar between groups (P > 0.05). Conclusions We found similar pregnancy outcomes with two endometrial preparation methods. Noting that each treatment centre should select the most beneficial and cost-effective method with the least adverse effects for patients, letrozole preparations for FET could be incorporated into possible options; however, establishing this approach as first-line treatment is premature in light of current evidence, and future randomized clinical trials with larger sample sizes are required for widespread application. Trial registration The study was also registered in the Iranian Registry of Clinical Trials on March 20th, 2020. (IRCT20090526001952N12 at www.irct.ir, registered retrospectively).

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“…Our study also found that the endometrial thickening in the LE group may be related to factors such as LE that do not affect the endometrial estrogen receptors, the short half-life of LE, and the increase of estrogen levels at follicular maturation. Wallace K.L., et al [4] reported from the molecular biology level that compared with CC ovulation-elevating LE, it can increase the endometrium LIF, DKKI. LIFR and FGF-22 gene expression and improve endometrial receptivity.…”

Section: Discussionmentioning

confidence: 99%

Clinical Observation of 242 Cases of Polycystic Ovary Syndrome

Shi¹,

Yi²

2018

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Objective: To compare the clinical effect and safety between letrozole (LE) and clomiphene citrate (CC) stimulated cycles in women with polycystic ovary syndrome (PCOS). To evaluate the effectivenesses and benefits of letrozole for ovulation induction in infertile women with PCOS. Methods: We retrospectively analyze the clinical data of 242 cases of the first ovulation induction cycle patients with PCOS, who referred to the Department of Reproductive Medicine, The First Affiliated Hospital of Yangtze University from June 2016 to June 2018, and were randomly divided into letrozole group and control group. The experimental group received Letrozole 2.5 mg/d for 5 days during days 3 -7 of menstrual cycle. The control group was given clomiphene citrate 100 mg/d for 5 days during days 3 -7 of menstrual cycle. Progynova will be used when the follicular diameter is 14 mm. Results: Letrozole group had less mature follicles, lower estrogen levels, thicker endometrium and higher ovulation rate in HCG day. But there is no difference between two groups in clinical pregnancy rate, single pregnancy rate, abortion rate, prenatal pregnancy delivery and newborns. Conclusion: Letrozole and clomiphene citrate have similar effect on ovulation induction, but we still need a lot of clinical data of letrozole about the safety of follicle, embryo, fetus and newborns.

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Clomiphene citrate versus letrozole: molecular analysis of the endometrium in women with polycystic ovary syndrome

Cited by 39 publications

References 37 publications

Differential profile of letrozole and exemestane on bone turnover markers in vinylcyclohexene diepoxide treated ovotoxic female mice

Differential profile of letrozole and exemestane on bone turnover markers in vinylcyclohexene diepoxide treated ovotoxic female mice

The effect of letrozole versus artificial hormonal endometrial preparation on pregnancy outcome after frozen-thawed embryos transfer cycles: a randomized clinical trial

Clinical Observation of 242 Cases of Polycystic Ovary Syndrome

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