Comparison of the efficiency of clomiphene citrate and letrozole in combination with metformin in moderately obese clomiphene citrate - resistant polycystic ovarian syndrome patients

Bjelica, Artur; Trninić-Pjević, Aleksandra; Mladenović-Segedi, Ljiljana; Ćetković, Nenad; Petrovic, Dan

doi:10.2298/sarh1604146b

Cited by 12 publications

(10 citation statements)

References 16 publications

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“…Similarly, Bjelica and fellows studied 60 moderately obese women with PCOS, treated with either clomiphene citrate-metformin 31 patients or letrozolemetformin combinations 29 patients. They found that the number of follicles that > 18 mm did not show a statistically significant difference between the two groups, which is in agreement with our results [18]. Contrariwise, AlFozan and co-workers found that the total numbers of follicles during stimulation were similar between the Letrozole and CC groups (5.5 ± 0.4 in the letrozole group, 4.8 ± 0.3 in the CC group).…”

Section: Discussionsupporting

confidence: 92%

Clomiphene-Metformin in Comparison with Letrozole-Metformin in Overweight Infertile Women with PCOS

EL-Gharib¹

2020

JOGRS

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Background: polycystic ovarian syndrome (PCOS) is a common cause of infertility and is associated with chronic anovulation and hyperandrogenemia. Clomiphene citrate (CC) is still the first-line therapy for ovulation induction in these patients. Metformin, a biguanide, has been used to treat insulin resistance in women with PCOS. Furthermore, many reports confirmed that the addition of metformin to CC in the CC-resistant PCOS was highly effective in achieving ovulation. Letrozole, an aromatase inhibitor, has attracted attention for a long time to induce ovulation. Aim of the work: In the current study, we aimed to compare the effect of administration of combined metformin–Clomiphene Citrate to that of combined metformin–letrozole in the induction of ovulation in infertile overweight women with PCOS. 40 infertile overweight cases with PCO were included. Methods: Sixty participants had received metformin in aggregate with both CC (100 mg) or and similar number received letrozole (5 mg) plus metformin for 5 days starting from 3rd day of their menstrual cycle. Results: The cumulative pregnancy rate CC-metformin was 21.66% and letrozole-metformin was 25%, the difference is insignificant. Conclusion: CC and letrozole are similarly viable in the treatment of overweight women with PCOS, when joined with metformin treatment.

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Section: Discussionsupporting

confidence: 92%

Clomiphene-Metformin in Comparison with Letrozole-Metformin in Overweight Infertile Women with PCOS

EL-Gharib¹

2020

JOGRS

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“…Nevertheless, HRT has strict indications and contraindications, which require that patients return regularly hospital so that the risks of treatment can be evaluated, and this limits its use in clinical applications (Panel, 2017). For ovulation induction, the first-line drug in clinical practices is clomiphene citrate, which causes thin endometrium as well as high ovulation and low pregnancy occurrence (Bjelica et al, 2016;Reed et al, 2018). Letrozole, an aromatase inhibitor traditionally used for breast cancer, is also used for ovulation induction.…”

Section: Introductionmentioning

confidence: 99%

Protective Effects and Possible Mechanisms of Actions of Bushen Cuyun Recipe on Diminished Ovarian Reserve Induced by Cyclophosphamide in Rats

et al. 2020

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Backgrounds: Diminished ovarian reserve (DOR) contributes significantly to female infertility. Bushen Cuyun Recipe (BCR, Tradename Yueliang Yin), a product marketed in China, has shown effects in the treatment of female infertility in clinical practices of traditional Chinese medicine (TCM). In this study, we aimed to investigate the chemical compositions of BCR and its efficacy based on scientific evidence and pharmacological mechanisms in DOR treatments. Methods: The chemical compositions of BCR were determined by the UHPLC-LTQ-Orbitrap MS method. DOR was induced in a rat model by intraperitoneal injection of cyclophosphamide (CTX) 90 mg/kg once. After the CTX treatment for 14 days, rats were intragastrically administrated deionized water, dehydroepiandrosterone (DHEA), or BCR in low, middle, and high doses for 30 days. Ovarian index, ovarian morphology, follicle number, and anti-Müllerian hormone (AMH) in serum were determined to assess the effects of BCR. To investigate possible action mechanisms, network pharmacological analysis was used to predict possible pathways in the effects of BCR on female infertility. In experimental studies, the contents of hormones in the hypothalamic-pituitary-ovarian axis (HPOA, including estradiol (E 2), follicle-stimulating hormone (FSH), and gonadotropinreleasing hormone (GnRH)) and pyroptosis-related proteins, including gasdermin D (GSDMD), caspase-1, and interleukin-18 (IL-18), in ovarian were detected by ELISA, immunofluorescence and Western blot. Results: Chemical studies revealed a total 84 components in BCR, which included 43 flavonoids, 13 triterpenoids, 11 phenolic acids, 8 alkaloids, 1 coumarin, 1 anthraquinone, and 7 other components. After treatments with BCR, the ovarian morphology, ovarian index, estrous cycle, growing follicles and corpus luteum from last ovulation, and serum AMH in DOR rats were significantly improved. Network pharmacological analysis suggested that the NOD-like receptor signaling pathway ranked No. 1 among the mechanisms by which BCR affects female infertility. Experimental results demonstrated

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“…Another study done among moderately obese women showed significantly higher pregnancy rate among the letrozole-metformin group (20.6%) than the CC-metformin group (9.6%) [20]. These higher pregnancy rates among letrozole group in most of the studies might be because letrozole was used among those PCOS women who were resistant to CC.…”

Section: Discussionmentioning

confidence: 96%

“…Use of metformin is associated with more controlled and orderly ovulation and fertility induction [8,11,17]. Many studies have been conducted to identify the combined effect of metformin with CC or letrozole [8,11,15,[18][19][20][21][22][23]. Improved results have been observed with combined medication than using CC or letrozole alone.…”

Section: Introductionmentioning

confidence: 99%

Combined Clomiphene Citrate-Metformin Versus Letrozole-Metformin in Achieving Pregnancy among Women with Polycystic Ovary Syndrome

Shrivastava¹,

Shrestha²,

Dhakal³

2019

Gynecol Reprod Health

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Background: Polycystic ovary syndrome is one of the most common causes of anovulatory sub-fertility in women of reproductive age-group. The therapeutic procedure for women with polycystic ovary syndrome wanting to be pregnant is ovulation induction. Different medicines have been used based on individual signs and symptoms as the most effective one is not clearly evident. Clomiphene citrate and letrozole are the most common drugs used alone or in combination with metformin to achieve pregnancy in women with polycystic ovary syndrome. In this study, the efficacy of combined clomiphene citrate-metformin is compared with letrozole-metformin in achieving pregnancy among women with polycystic ovary syndrome. Methods: A retrospective study was performed among women with polycystic ovary syndrome attending Infertility Center, Kathmandu, Nepal from January 2013 to December 2015. Samples were randomly selected from list of the record in the treatment centre within the study duration. Total 146 cases with 73 each in clomiphene citratemetformin group and letrozole-metformin group were entered into the analysis. Participants had received metformin in combination with either clomiphene citrate (100 mg) or letrozole (2.5 mg) from day 3 to 5 of their menstrual cycle. Odds ratio, with confidence interval set at 95%, was calculated to compare the efficacy between two groups. Results: The pregnancy rate of clomiphene citrate-metformin was 54.79% and letrozole-metformin was 34.25%. Patients treated with clomiphene citrate-metformin were two times more likely to get pregnant [OR: 2.33, 95% CI: 1.19-4.54] than those treated with letrozole-metformin. Miscarriage rate was not found to be statistically significant. Conclusion: Clomiphene citrate in combination with metformin is more likely to be effective than letrozole with metformin in achieving pregnancy.

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Comparison of the efficiency of clomiphene citrate and letrozole in combination with metformin in moderately obese clomiphene citrate - resistant polycystic ovarian syndrome patients

Abstract: This retrospective study demonstrated the advantages of the use of letrozole over clomiphene citrate in combination with metformin in moderately obese patients with polycystic ovary syndrome who are resistant to stimulation with clomiphene citrate alone.

Cited by 12 publications

References 16 publications

Clomiphene-Metformin in Comparison with Letrozole-Metformin in Overweight Infertile Women with PCOS

Clomiphene-Metformin in Comparison with Letrozole-Metformin in Overweight Infertile Women with PCOS

Protective Effects and Possible Mechanisms of Actions of Bushen Cuyun Recipe on Diminished Ovarian Reserve Induced by Cyclophosphamide in Rats

Combined Clomiphene Citrate-Metformin Versus Letrozole-Metformin in Achieving Pregnancy among Women with Polycystic Ovary Syndrome

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