Letrozole co-treatment in infertile women 40 years old and older receiving controlled ovarian stimulation and intrauterine insemination

Bedaiwy, Mohamed A.; Shokry, Mahmoud; Mousa, Noha A.; Claessens, Anne; Esfandiari, Navid; Gotleib, Lynda; Casper, Robert F.

doi:10.1016/j.fertnstert.2008.03.020

Cited by 21 publications

(13 citation statements)

References 51 publications

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“…In addition, our ovulation monitoring findings agree with a previous study showing multifollicular development and better pregnancy outcomes with the use of letrozole 5 mg/day [14,17]. Our finding that serial serum progesterone levels were comparable between the three groups agrees with a previous study [18], and suggests that letrozole does not have a premature luteinizing effect on the developing follicle. Table 6 summarizes the results of some trials using letrozole as an ovulation inducing agent in different clinical scenaria with different results and conclusions.…”

Section: Discussionsupporting

confidence: 92%

“…The endometrial-sparing effect of letrozole is well-demonstrated in this study by the lack of significant difference in endometrial thickness compared to the natural cycle group, and also has been confirmed by previous studies [17,18]. In addition, our ovulation monitoring findings agree with a previous study showing multifollicular development and better pregnancy outcomes with the use of letrozole 5 mg/day [14,17].…”

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

Hormonal, follicular and endometrial dynamics in letrozole-treated versus natural cycles in patients undergoing controlled ovarian stimulation

Bedaiwy

Abdel-Aleem

Hussein

et al. 2011

Reprod Biol Endocrinol

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The objective of this study was to compare letrozole-stimulated cycles to natural cycles in 208 patients undergoing intrauterine insemination (IUI) between July of 2004 and January of 2007. Group I (n = 47) received cycle monitoring only (natural group), Group II (n = 125) received letrozole 2.5 mg/day on cycle days three to seven, and Group III (n = 36) received letrozole 5 mg/day on cycle days three to seven. There were no differences between the groups in endometrial thickness or P4 on the day of hCG. Estradiol levels had higher variation in the second half of the follicular phase in both letrozole-treated groups compared to the control group. Estradiol per preovulatory follicle was similar in both letrozole cycles to that observed in the natural cycles. LH was lower on the day of hCG administration in the letrozole 2.5 mg/day group vs. the natural group. In summary, letrozole results in some minor changes in follicular, hormonal and endometrial dynamics compared to natural cycles. Increased folliculogenesis and pregnancy rates were observed in the letrozole-treated groups compared to the natural group. These findings need to be confirmed in larger, prospective studies.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Hormonal, follicular and endometrial dynamics in letrozole-treated versus natural cycles in patients undergoing controlled ovarian stimulation

Bedaiwy

Abdel-Aleem

Hussein

et al. 2011

Reprod Biol Endocrinol

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“…Concern was expressed with the rate of pregnancy loss (from 5 chemical pregnancies to 3 patients delivering) but it should be emphasized that larger, controlled studies must be conducted to further evaluate this initial observation. This contention is supported by a recent report [36] in which 159 infertile women undergoing controlled ovarian stimulation and artificial insemination treated with the aromatase inhibitor, letrozole in combination with FSH, exhibited comparable pregnancy rates with less cancelled cycles and less FSH required for stimulation compared to FSH-treated patients alone.…”

Section: Reviewmentioning

confidence: 76%

The emerging use of aromatase inhibitors for endometriosis treatment

Nothnick

2011

Reprod Biol Endocrinol

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Endometriosis is defined as the growth of endometrial tissue outside of the uterine cavity. The disease occurs primarily in women of reproductive age but recurrent endometriosis is also detected in post-menopausal women. Regardless of age, endometriosis is associated with pain and reduces the quality of life for millions of women world-wide. Conventional therapies focus on reducing systemic levels of estrogen which results in cessation of endometriotic implant growth and pain symptoms associated with the disease. However, these treatments are not effective in all women and are not without side effects. Based upon the discovery that endometriotic tissue over-expresses aromatase, an enzyme critical for estrogen production, emphasis has been placed upon the use of aromatase inhibitors for the treatment of endometriosis and its associated symptoms. This article will review the rationale behind the use of aromatase inhibitors in treating endometriosis and summarize those studies which have evaluated the use of aromatase inhibitors in the treatment of endometriosis and its associated symptoms.

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“…gonadotropins, or gonadotropins alone in terms of comparable if not higher CPR/cycle and take home baby rates. Significantly higher serum levels of LH, endometrial thickness, and progesterone at the time of hCG administration have been observed despite a significantly lower serum E2 level [29][30][31] with significantly lower costs, risks, and patient inconvenience in patients with unexplained infertility [29,30,32,33] endometriosis, and combined indications [34], and lower FSH dose requirement and IUI cancelation rates in patients with ovulatory infertility [35] and older infertile women [31].…”

Section: Discussionmentioning

confidence: 99%