Effectiveness and safety of aspirin combined with letrozole in the treatment of polycystic ovary syndrome: a systematic review and meta-analysis

Yu, Qinjian; Wang, Zhihui; Su, Fangfang; Wang, Mianmian

doi:10.21037/apm-21-606

Cited by 6 publications

(4 citation statements)

References 9 publications

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“…3 A recent metaanalysis including 10 randomized clinical trials (RCTs) with 948 women with PCOS evaluated the association of low-dose aspirin in combination with letrozole with fertility in women with PCOS. 81 The authors found that adding aspirin to letrozole significantly improves reproductive outcomes, including increased pregnancy rate and decreased miscarriage rate. However, the authors called for further verification in multi-centre, large-sample, high-quality RCTs.…”

Section: Medicationsmentioning

confidence: 99%

“…Letrozole is considered as the first‐line pharmacological treatment for ovulation induction in women with PCOS with anovulatory infertility and without other infertility factors 3 . A recent meta‐analysis including 10 randomized clinical trials (RCTs) with 948 women with PCOS evaluated the association of low‐dose aspirin in combination with letrozole with fertility in women with PCOS 81 . The authors found that adding aspirin to letrozole significantly improves reproductive outcomes, including increased pregnancy rate and decreased miscarriage rate.…”

Section: Recommendations From Guidelines For Implementation In Health...mentioning

confidence: 99%

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Clinical management of pregnancy in women with polycystic ovary syndrome: An expert opinion

Khomami

Teede

Joham

et al. 2022

Clinical Endocrinology

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Polycystic ovary syndrome (PCOS) is associated with a higher risk for pregnancy and birth complications according to the specific features associated with PCOS.The features include obesity before and during pregnancy, hyperandrogenism, insulin resistance, infertility, cardiometabolic risk factors, and poor mental health.PCOS is not often recognized as a risk factor for poor pregnancy and birth outcomes in pregnancy care guidelines, while its associated features are. Pregnancy-related risk profile should ideally be assessed for modifiable risk factors (e.g., lifestyle and weight management) at preconception in women with PCOS. Hyperglycaemia should be screened using a 75-g oral glucose tolerance test at preconception or within the first 20 weeks of pregnancy if it has not been performed at preconception and should be repeated at 24-28 weeks of pregnancy. In the absence of evidence of benefit for strategies specific to women with PCOS, the international evidencebased guidelines for the assessment and management of PCOS recommend screening, optimizing, and monitoring risk profile in women with PCOS (at preconception, during and postpregnancy) consistent with the recommendations for the general population. Recommended factors include blood glucose, weight, blood pressure, smoking, alcohol, diet, exercise, sleep and mental health, emotional, and sexual health among women with PCOS. The guidelines recommend Metformin in addition to lifestyle for assisting with weight management and improving cardiometabolic risk factors, particularly in those with overweight or obesity.

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Section: Medicationsmentioning

confidence: 99%

Section: Recommendations From Guidelines For Implementation In Health...mentioning

confidence: 99%

Clinical management of pregnancy in women with polycystic ovary syndrome: An expert opinion

Khomami

Teede

Joham

et al. 2022

Clinical Endocrinology

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show abstract

“…Low-dose aspirin has been co-administered with a variety of other medications for ovulation induction in women with PCOS-related infertility. These include clomid [ 248 ], letrozole [ 249 ], tamoxifen [ 250 ], and Chinese medicine [ 251 ]. When considered together, these studies report improved oocyte quality, higher pregnancy rates, and increased endometrial thickness.…”

Section: Identification Assessment and Management Of Women With Pcos ...mentioning

confidence: 99%

Reducing the Risk of Pre-Eclampsia in Women with Polycystic Ovary Syndrome Using a Combination of Pregnancy Screening, Lifestyle, and Medical Management Strategies

Parker,

O’Brien,

Yeoh

et al. 2024

JCM

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Polycystic ovary syndrome (PCOS) is a multisystem disorder that presents with a variety of phenotypes involving metabolic, endocrine, reproductive, and psychological symptoms and signs. Women with PCOS are at increased risk of pregnancy complications including implantation failure, miscarriage, gestational diabetes, fetal growth restriction, preterm labor, and pre-eclampsia (PE). This may be attributed to the presence of specific susceptibility features associated with PCOS before and during pregnancy, such as chronic systemic inflammation, insulin resistance (IR), and hyperandrogenism, all of which have been associated with an increased risk of pregnancy complications. Many of the features of PCOS are reversible following lifestyle interventions such as diet and exercise, and pregnant women following a healthy lifestyle have been found to have a lower risk of complications, including PE. This narrative synthesis summarizes the evidence investigating the risk of PE and the role of nutritional factors in women with PCOS. The findings suggest that the beneficial aspects of lifestyle management of PCOS, as recommended in the evidence-based international guidelines, extend to improved pregnancy outcomes. Identifying high-risk women with PCOS will allow targeted interventions, early-pregnancy screening, and increased surveillance for PE. Women with PCOS should be included in risk assessment algorithms for PE.

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“…Low-dose aspirin has been co-administered with a variety of other medications for ovulation induction in women with PCOS-related infertility. These include clomid [192], letrozole [193], tamoxifen [194], and Chinese medicine [195]. When considered together, these studies report improved oocyte quality, higher pregnancy rates, and increased endometrial thickness.…”

Section: Identification Assessment and Management Of Women With Pcos ...mentioning

confidence: 99%

Reducing the Risk of Pre-eclampsia in Women with Polycystic Ovary Syndrome using a Combination of Pregnancy Screening, Lifestyle, and Medical Management Strategies

Parker,

O'Brien,

Yeoh

et al. 2023

Preprint

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Polycystic ovary syndrome (PCOS) is a multisystem disorder that presents with a variety of phenotypes involving metabolic, endocrine, reproductive, and psychological symptoms and signs. Women with PCOS are at increased risk of pregnancy complications including implantation failure, miscarriage, gestational diabetes, fetal growth restriction, preterm labour, and preeclampsia (PE). This may be attributed to the presence of specific susceptibility features associated with PCOS before and during pregnancy, such as chronic systemic inflammation, insulin resistance (IR), and hyperandrogenism, all of which have been associated with an increased risk of pregnancy complications. Many of the features of PCOS are reversible following lifestyle interventions such as diet and exercise, and pregnant women following a healthy lifestyle have been found to have a lower risk of complications, including PE. This review summarizes the evidence investigating the risk of PE and the role of nutritional factors in women with PCOS. The findings suggest that the beneficial aspects of lifestyle management of PCOS, as recommended in the evidenced-based international guidelines, extend to improved pregnancy outcomes. Identifying high-risk women with PCOS will allow targeted interventions, early pregnancy screening, and increased surveillance for PE. Women with PCOS should be included in risk assessment algorithms for PE.

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Effectiveness and safety of aspirin combined with letrozole in the treatment of polycystic ovary syndrome: a systematic review and meta-analysis

Cited by 6 publications

References 9 publications

Clinical management of pregnancy in women with polycystic ovary syndrome: An expert opinion

Clinical management of pregnancy in women with polycystic ovary syndrome: An expert opinion

Reducing the Risk of Pre-Eclampsia in Women with Polycystic Ovary Syndrome Using a Combination of Pregnancy Screening, Lifestyle, and Medical Management Strategies

Reducing the Risk of Pre-eclampsia in Women with Polycystic Ovary Syndrome using a Combination of Pregnancy Screening, Lifestyle, and Medical Management Strategies

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