Dosage Optimization for Letrozole Treatment in Clomiphene-Resistant Patients with Polycystic Ovary Syndrome: A Prospective Interventional Study

Rahmani, Elham; Ahmadi, Shahnaz; Motamed, Niloofar; Maneshi, Hesam_Oddin

doi:10.1155/2012/758508

Cited by 10 publications

(10 citation statements)

References 19 publications

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“…The lower ovulation and pregnancy rate seen could be due to the and clomiphene resistant (37.3). (Morad and Farag [24] ) showed that the pregnancy rate was 20% in letrozole use after clomiphene failure while ovulation and pregnancy rate after clomiphene resistant was 44.24% and 23.89% respectively in (Rahmani, et al [25] ) study vs. 51.2% and 27.9% respectively in our study; on the other hand, (Mitwally and Casper [26] ) study showed ovulation rate of 75% and the pregnancy rate of 25%. In clinical practice searching for predictors to response to OI treatment in women with PCOS may help the clinicians to manage these patients appropriately.…”

Section: Discussioncontrasting

confidence: 43%

Predictors for Response to Letrozole as an Ovulation Induction in Anovulatory Infertile Polycystic Ovarian Syndrome Women

Alizzi¹,

Showman²,

Fawzi³

2019

IJEIR

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To assess the predictive value of different clinical, laboratory, and ultrasound parameters in Letrozole when used as an ovulation induction in anovulatory infertile PCOS women. The current study was done in the secondary-referral infertility clinic in AL-Yarmouk teaching hospital, and Al-Mustansiriyah medical college. Sixty-seven anovulatory infertile women with the polycystic ovarian syndrome. Letrozole was given orally on day 2 or 3 of the menstrual cycle for five days and repeated for three consecutive cycles. The primary outcome measures were to evaluate the response rate in the form of successful ovulation and clinical pregnancy. The ovulation rate was (64.2%), with clomiphene naïve vs. previous clomiphene use; it was 87.5%, 51.2% respectively, while pregnancy rate was (32.8%), 41.6% with clomiphene naïve vs. 27.9% with previous clomiphene use. Clinical (age, BMI, Waist circumference, cycle length and days between cycle, infertility period and type, previous reproductive outcome, androgen symptom and m-FG score), laboratory (E 2 , FSH, LH, testosterone, FAI, FBS, fasting insulin, HOMA-IR, and AMH) and ultrasound (mean ovarian volume, mean AFC and antral follicular diameter) parameters were founded to affect ovulation and pregnancy in different extent. After putting all variables in a scoring system, it was found that if the patients had > 26 points for the score, it's more likely that the woman becomes pregnant. A predictive pregnancy score was developed from basic clinical, laboratory, and ultrasound parameters. It may help the clinician to individualized ovulation induction protocol in PCOS women; however, external validation of this system is recommended in a more extensive prospective study.

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Section: Discussioncontrasting

confidence: 43%

Predictors for Response to Letrozole as an Ovulation Induction in Anovulatory Infertile Polycystic Ovarian Syndrome Women

Alizzi¹,

Showman²,

Fawzi³

2019

IJEIR

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“…To start with dosage is usually begun at 2.5 mg daily and the basis of development of adequacy of follicular size and endometrial thickness, as deemed necessary the dose could be increased to 5 mg and subsequently to 7.5 mg daily in the consecutive cycle on the basis of individual response. 28 Letrozole as a side effects could cause fatigue and dizziness. But importantly concerns on congenital anomalies in fetus with letrozole therapy were raised.…”

Section: Selective Estrogen Receptor Modulators-clomiphene Citratementioning

confidence: 99%

Ovulation induction in polycystic ovarian syndrome - basics for gynecologist

Yadav¹

2021

Int J Reprod Contracept Obstet Gynecol

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Polycystic ovarian syndrome (PCOS) is the most common problem related to infertility among women. This review looked into the evidence and options available for ovulation induction. The management protocol and their respective efficacy was looked into during the write up of the review. Weight reduction, along with metformin therapy are the initial and efficient way to regain ovulation among obese female. This should be complemented by use of first line medicine like aromatase inhibitors and selective estrogen receptor modulators. The first line is effective in significant proportion of female to induce ovulation and increase live birth rate. However, for those not responding should initially undergo the use of gonadotropins and ovarian drilling. Finally, controlled ovarian stimulation and in vitro fertilization should be considered as it is an invasive, expensive and there are risks of ovarian hyperstimulation and multiple gestation.

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“…The ovulation and pregnancy rate were found to be 44.24 % and 23.89% respectively. 36 Elnashar A et al studied 44 infertile women with Clomiphene citrate resistance who received Letrozole 2.5 mg /day for 5 days. The ovulation rate and pregnancy rate was found to be 54.6% and 25% respectively.…”

Section: Efficacy Of Letrozole In Overcoming Infertility In Various Pmentioning

confidence: 99%

Letrozole: an emerging array of hope for infertile women

Maladkar¹,

Tekchandani²,

Karchodi³

2020

Int J Reprod Contracept Obstet Gynecol

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Ovulation induction has been a major breakthrough in the management of female infertility since many decades. Letrozole, an aromatase inhibitor has been used as a potential therapy for ovulation induction. A large number of clinical evidences have been emerging which cite the beneficial role of Letrozole in conditions like anovulatory infertility, polycystic ovary syndrome (PCOS), unexplained infertility and an incipient role in endometriosis- related infertility with regards to higher live-birth rates. Letrozole is a superior alternative to Clomiphene citrate (CC) which has been used conventionally as ovulation inducer. Clomiphene citrate has certain well-defined disadvantages, whereas Letrozole overcomes these limitations to a reasonable extent. The peripheral anti-estrogenic effect of CC leads to prolonged depletion of estrogens receptors, adversely affecting endometrial growth and development as well as quantity and quality of cervical mucus. Persistent blockade of estrogen receptor leads to CC resistance and is associated with reduced ovulation and pregnancy rates. Available evidences suggest Letrozole is superior to CC owing to the lack of persistent anti-estrogenic action due to its short half- life and lack of action on estrogen receptors. This typically leads to monofollicular growth and also higher live birth rates. The current evidences suggest that Letrozole can be placed as first line therapy for the management of infertility due to PCOS and unexplained infertility.

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Dosage Optimization for Letrozole Treatment in Clomiphene-Resistant Patients with Polycystic Ovary Syndrome: A Prospective Interventional Study

Cited by 10 publications

References 19 publications

Predictors for Response to Letrozole as an Ovulation Induction in Anovulatory Infertile Polycystic Ovarian Syndrome Women

Predictors for Response to Letrozole as an Ovulation Induction in Anovulatory Infertile Polycystic Ovarian Syndrome Women

Ovulation induction in polycystic ovarian syndrome - basics for gynecologist

Letrozole: an emerging array of hope for infertile women

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