Comparison of efficacy of letrozole and clomiphene citrate for induction of ovulation

Jawad, Ariana Khalis; M.D., MOHAMED E. ALI, M.D.; HEBA A. ELSWAH,; Jawad, Rojan K

doi:10.15218/zjms.2020.004

Cited by 3 publications

(2 citation statements)

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“…[4][5][6][7][8][9][10] Letrozole was proposed as an alternative to clomiphene citrate as a highly selective aromatase inhibitor that prevents androgen to estrogen conversion. 5,11 Their mechanism is the release of the hypothalamicpituitary axis from estrogenic negative feedback, thereby increasing gonadotropin secretion and resulting in stimulation of ovarian follicles. In addition, it has a local effect on the ovary, and androgen accumulation increases follicle sensitivity to FSH.…”

Section: Introductionmentioning

confidence: 99%

“…12 This aromatase inhibitor has a short half-life (45 hours); 4,9 thus, it is rapidly eliminated from the body. No adverse effects on estrogen receptor (ER) and endometrium are seen with Letrozole due to short half-life 7,11 , unlike Clomiphene Citrate. 13 Endometrial thickness, Triple line pattern and vascularity of endometrium are the essential determinants that can predict Endometrial Receptivity.…”

Section: Introductionmentioning

confidence: 99%

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Endometrial changes in Infertile Women with Polycystic Ovary Syndrome after taking Letrozole in Comparison to Clomiphene Citrate

Mahmuda,

Sultana,

Rahman

et al. 2023

Bangladesh J Obstet Gynaecol

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Background: The endometrium is a receptor organ for most of the hormones involved in fertility and therefore the study of its morphology is thought to explain the mysteries of implantation failure. Many studies showed that Clomiphene Citrate impairs endometrial development due to antiestrogenic effects and long half-life. Conversely Letrozole shows a positive effect on follicle and endometrium. Objective: To assess the endometrium in infertile Polycystic Ovary Syndrome women by Transvaginal Sonography after giving ovulation induction by Clomiphene Citrate versus Letrozole. Materials and Methods: This Comparative cross-sectional study was conducted on sixty diagnosed Polycystic Ovary Syndrome infertile women in the Reproductive Endocrinology & Infertility Unit of Dhaka medical College Hospital, Dhaka, from January 2021 to December 2021. The patients who took Letrozole is called Letrozole group and who took Clomiphene citrate is called Clomiphene citrate group. Serial folliculometry were done to every patient from Day 7. At day 12, the patients were assessed by Transvaginal Sonography for endometrial study. The hyporesponsive and non-responsive patients took higher dose of clomiphene citrate or letrozole in next cycle and serial folliculometry were done as before. Endometrial thickness, pattern and zone of vascularity was compared between the two groups. Preovulatory S. Estradiol was done in case of optimum response. All the relevant data were collected in a predesigned and pretested case record form. Data was processed and analyzed with the help of the computer program SPSS in version 26. Results: Clomiphene Citrate and Letrozole achieved optimum response in 15(50%) and 21(70%) patients, respectively. The Letrozole group had a significantly greater endometrial thickness than the Clomiphene Citrate group (8.85±1.33 vs.7.37±1.07, p=0.001s). Moreover, the Letrozole group showed a greater number of triple line endometrium (76.2% vs 60.0%, p=0.298ns), grade A (42.9% vs 26.7%, p=0.500 ns ) and Zone 3 vascularity (33.3%vs 22.2%, p=0.325 ) than the clomiphene citrate group. Conclusion: Letrozole induces significantly better endometrial development in terms of endometrial thickness than clomiphene citrate. Bangladesh J Obstet Gynaecol, 2022; Vol. 37(1): 5-13

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Endometrial changes in Infertile Women with Polycystic Ovary Syndrome after taking Letrozole in Comparison to Clomiphene Citrate

Mahmuda,

Sultana,

Rahman

et al. 2023

Bangladesh J Obstet Gynaecol

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Comparison of Letrozole and Clomiphene Citrate in Pregnancy Outcomes in Patients with Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis

Abu-Zaid,

Gari,

Sabban

et al. 2023

Reprod. Sci.

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Letrozole Versus Clomiphene Citrate for Superovulation in Intrauterine Insemination Cycles - Retrospective Comparative Study Conducted in the Department of Reproductive Medicine, Mahatma Gandhi Medical College & Hospital, Jaipur

Chishti¹,

Chowdhary²,

Paliwal³

et al. 2021

jemds

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BACKGROUND Superovulation with intrauterine insemination (IUI) increases the probability of pregnancy by increasing number of oocytes and sperm density. The main oral agents used for superovulation are clomiphene citrate and letrozole. Clomiphene citrate a selective estrogen receptor modulator with predominant antiestrogenic action has adverse effects on endometrium and cervical mucous. Letrozole an aromatase inhibitor acts by reducing estrogen production by blocking androgen conversion to estrogen in ovary and peripheral tissues without affecting endometrium and cervical mucous. We wanted to compare the efficacy of letrozole v/s clomiphene citrate as first line ovulation induction drug in infertile patients undergoing IUI. METHODS Based on the inclusion and exclusion criteria, we included 160 patients in our study. They were divided into two groups of 80 each based on the drug given for ovulation induction. The drug was given for 5 days from D3 to D7 of menstrual cycle. IUI was done 38 - 40 hours after trigger and after confirmation of ovulation by sonography. RESULTS The mean age, body mass index (BMI), duration of infertility, type and cause of infertility in both groups were similar. Ovulation rate was 85 % in letrozole group and 71.25 % in clomiphene citrate group, which was statistically significant (P0.035). There was no statistically significant difference between endometrial thickness and total days till ovulation between two groups. Monofolliculogenesis and clinical pregnancy rate were statistically significantly higher in letrozole group. CONCLUSIONS Our study shows that letrozole has better pregnancy rate in comparison to clomiphene citrate (C. C.) in IUI cycles with less risk of anovulation, thin endometrium and multi follicular growth. KEY WORDS Clomiphene Citrate (C.C.), Letrozole (LTZ), Ovulation Induction (OI), Intrauterine Insemination (IUI)

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Comparison of efficacy of letrozole and clomiphene citrate for induction of ovulation

Cited by 3 publications

References 0 publications

Endometrial changes in Infertile Women with Polycystic Ovary Syndrome after taking Letrozole in Comparison to Clomiphene Citrate

Endometrial changes in Infertile Women with Polycystic Ovary Syndrome after taking Letrozole in Comparison to Clomiphene Citrate

Comparison of Letrozole and Clomiphene Citrate in Pregnancy Outcomes in Patients with Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis

Letrozole Versus Clomiphene Citrate for Superovulation in Intrauterine Insemination Cycles - Retrospective Comparative Study Conducted in the Department of Reproductive Medicine, Mahatma Gandhi Medical College & Hospital, Jaipur

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