Comparison of the Effect of Clomiphene- Estradiol Valerate vs Letrozole on Endometrial Thickness, Abortion and Pregnancy Rate in Infertile Women with Polycystic Ovarian Syndrome

Seyedoshohadaei, Fariba; Tangestani, Laleh; Zandvakili, Farnaz; Rashadmanesh, Naser

doi:10.7860/jcdr/2016/20954.8324

Cited by 23 publications

(30 citation statements)

References 25 publications

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“…Xi et al 18 reported similar results. Three studies have reported a significantly higher ET with letrozole compared with CC 12,17,19 . In contrast, two studies reported a significantly higher ET with CC 4,13 …”

Section: Discussionmentioning

confidence: 91%

“…However, these studies are heterogeneous with regard to the patient characteristics (BMI) and intervention (drug dosage, maximum cycles). It is possible that variations in the techniques of measurement, use of adjuncts, 12,17 as well as patient characteristics (BMI), might have affected the ET as well as its measurement. It has also been postulated that ET might be thinner with letrozole compared with CC because of multifollicular development with the latter leading to higher estradiol levels and hence thicker endometrium 4 …”

Section: Discussionmentioning

confidence: 99%

“…This has a favorable effect on the endometrium and hence on pregnancy rates 8 . Various clinical trials have compared the efficacy of letrozole and CC in infertile women with PCOS 3,4,9–13 . These studies have also been analyzed in a Cochrane systematic review and a recent individual patient data meta‐analysis 14,15 .…”

Section: Introductionmentioning

confidence: 99%

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Letrozole versus clomiphene citrate for ovulation induction in anovulatory women with polycystic ovarian syndrome: A randomized controlled trial

Bansal

Goyal

Sharma

et al. 2020

Intl J Gynecology & Obste

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Objective To compare the efficacy of letrozole and clomiphene citrate (CC) for ovulation induction in infertile women with polycystic ovarian syndrome (PCOS). Methods In this assessor blind, randomized controlled trial, 90 infertile women with PCOS were randomized to receive either letrozole or CC for ovulation induction in incremental doses for a maximum of three cycles. Main outcome measures studied were endometrial thickness, ovulation rate, pregnancy rate, rate of monofollicular development, and time to conception. Results Mean endometrial thicknesses were 9.86 ± 2.32 mm and 9.39 ± 2.06 mm with letrozole and CC, respectively (P=0.751). Cumulative ovulation rates were 86.7% and 85.2% with letrozole and CC, respectively (P=0.751). Pregnancy was achieved in 42.2% of women in the letrozole group and 20.0% of women in the CC group (P=0.04). Monofollicular development was seen in 68.4% of ovulatory cycles in the letrozole group compared with 44.8% in the CC group (P=0.000). Mean time to achieve pregnancy was significantly shorter (log rank P=0.042) with letrozole (9.65 weeks) than with CC (11.07 weeks). Conclusion Letrozole is a better alternative for ovulation induction in anovulatory women with PCOS as pregnancy rates are higher, time to pregnancy is shorter, and chances of multiple pregnancy are less because of high monofollicular growth.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Letrozole versus clomiphene citrate for ovulation induction in anovulatory women with polycystic ovarian syndrome: A randomized controlled trial

Bansal

Goyal

Sharma

et al. 2020

Intl J Gynecology & Obste

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“…It has been demonstrated that E 2 can effectively promote endometrial regeneration and form new capillaries after menstruation. 11 Estrogen therapy is commonly used as an ancillary treatment after adhesiolysis since it accelerates the regeneration of the endometrial layer and therefore prevents recurrent adhesions. 12 Evidence from many studies indicates that the application of estrogen therapy in patients with IUA results in satisfactory outcomes.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional structure micelles of heparin-poloxamer improve the therapeutic effect of 17β-estradiol on endometrial regeneration for intrauterine adhesions in a rat model

Zhang¹,

Xia²,

Xu³

et al. 2017

IJN

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Intrauterine adhesions (IUA) frequently occur after infectious or mechanical injury to the endometrium, which may lead to infertility and/or pregnancy complications. There are few effective treatments due to the complex function of endometrium and shortage of native materials. 17β-estradiol (E 2 ) is commonly used as an ancillary treatment in IUA patients, but it is limited by its poor solubility in aqueous solutions and low concentrations at the injured sites. In this research, a mini-endometrial curette was used to injure the rat’s endometrium to form an IUA model. 17β-estradiol was encapsulated into the micelles of heparin-poloxamer and a thermosensitive hydrogel (E 2 -HP hydrogel) was formed. This sustained releasing system was applied to restore the structure and function of the injured uterus. E 2 -HP hydrogel was constructed and relevant characteristics including gelation temperature and micromorphology were evaluated. Sustained release of 17β-estradiol from HP hydrogel was performed both in vitro and in vivo. Ultrasonography measurement and pathologic characteristics on the IUA rats were performed to evaluate the therapeutic effect of E 2 -HP hydrogel. Endoplasmic reticulum (ER) stress-related apoptosis was analyzed to explore the possible mechanisms in IUA recovery. E 2 -HP hydrogel showed a prolonged release of E 2 at the targeting region and more effective endometrium regeneration in IUA rats. Significant improvements in both gland numbers and fibrosis area were observed in the E 2 -HP hydrogel group. We also demonstrated that E 2 -HP hydrogel in the recovery of IUA was closely related to the suppression of ER stress signals via the activation of downstream signals, PI3K/Akt and ERK1/2. HP hydrogel might be an effective approach to deliver E 2 into the injured endometrium. Therapeutic strategies targeting ER stress using E 2 -HP hydrogel might be a promising solution for the treatment of women with intrauterine adhesions.

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“…In group-B mean endometrial thickness on day 3 was 5.3 mm, on day 10 was 6.8 mm, day 12 was 6.8 mm, day 14 was 7.4 mm, day 16 was 8.3 mm, day 18 was 8.3 mm and on day of rupture endometrial thickness was 8.5 mm. Seyedoshohadaei F et al (2016) 8 showed that endometrial thickness was increased after administration of Clomiphene plus Estradiol Valerate and Letrozole, but there was significantly different in the two groups (p<.05). In Letrozole group endometrial thickness was higher than Clomiphene plus Estradiol Valerate.…”

Section: Resultsmentioning

confidence: 96%

Comparison of Effect of Clomiphene Citrate With Estradiol Valerate v/S Letrozole on Pregnancy Rate in Infertile Women With Pcos

Mendiratta

Kumar

2020

IJMBS

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Background: Polycystic ovary syndrome is the commonest endocrinopathy in anovulatory infertility in young women. It is estimated that infertility affects 10 to 14% of the Indian population of which approximately 25-30% part occupied by PCOS. Methods: This prospective study enrolled 180 infertile women with PCOS, age 21-35 yrs who have taken 1 cycle of clomiphene citrate 100 mg, endometrial thickness <7 mm inspite of follicles greater than 18 mm. Half of them treated with clomiphene citrate with estradiol valerate and remaining half with letrozole. Results: In Group-A treated with clomiphene citrate with estradiol valerate 13 patients (16.3%) conceived and in Group-B treated with letrozole 26 patients (32.5%) conceived. Conclusion: Pregnancy rate is higher in group which treatment with letrozole in comparison with clomiphene citrate plus estradiol valerate. Keywords: Polycystic ovary syndrome, Infertility, Pregnancy rate

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Comparison of the Effect of Clomiphene- Estradiol Valerate vs Letrozole on Endometrial Thickness, Abortion and Pregnancy Rate in Infertile Women with Polycystic Ovarian Syndrome

Cited by 23 publications

References 25 publications

Letrozole versus clomiphene citrate for ovulation induction in anovulatory women with polycystic ovarian syndrome: A randomized controlled trial

Letrozole versus clomiphene citrate for ovulation induction in anovulatory women with polycystic ovarian syndrome: A randomized controlled trial

Three-dimensional structure micelles of heparin-poloxamer improve the therapeutic effect of 17β-estradiol on endometrial regeneration for intrauterine adhesions in a rat model

Comparison of Effect of Clomiphene Citrate With Estradiol Valerate v/S Letrozole on Pregnancy Rate in Infertile Women With Pcos

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Comparison of the Effect of Clomiphene- Estradiol Valerate vs Letrozole on Endometrial Thickness, Abortion and Pregnancy Rate in Infertile Women with Polycystic Ovarian Syndrome

Cited by 23 publications

References 25 publications

Letrozole versus clomiphene citrate for ovulation induction in anovulatory women with polycystic ovarian syndrome: A randomized controlled trial

Letrozole versus clomiphene citrate for ovulation induction in anovulatory women with polycystic ovarian syndrome: A randomized controlled trial

Three-dimensional structure micelles of heparin-poloxamer improve the therapeutic effect of 17&beta;-estradiol on endometrial regeneration for intrauterine adhesions in a rat model

Comparison of Effect of Clomiphene Citrate With Estradiol Valerate v/S Letrozole on Pregnancy Rate in Infertile Women With Pcos

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Three-dimensional structure micelles of heparin-poloxamer improve the therapeutic effect of 17β-estradiol on endometrial regeneration for intrauterine adhesions in a rat model