Letrozole induction of ovulation in women with clomiphene citrate–resistant polycystic ovary syndrome may not depend on the period of infertility, the body mass index, or the luteinizing hormone/follicle-stimulating hormone ratio

Elnashar, Aboubakr; Fouad, Hany Ahmed; Eldosoky, Magy; Saeid, Naser

doi:10.1016/j.fertnstert.2005.08.016

Cited by 62 publications

(51 citation statements)

References 11 publications

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“…Several smaller prospective randomized trials have also shown that letrozole may be an acceptable alternative to CC as an ovulation induction drug in women with PCOS [24][25][26]. An ovulation rate of 54.6% and pregnancy rate of 25% with letrozole induction in CC-resistant women with PCOS is reported [2]. We observed the ovulation rate to be 79.3% and the pregnancy rate 23.39% with letrozole.…”

Section: Discussionmentioning

confidence: 49%

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Comparison of letrozole with continuous gonadotropins and clomiphene-gonadotropin combination for ovulation induction in 1387 PCOS women after clomiphene citrate failure: a randomized prospective clinical trial

Ganesh

Goswami

Chattopadhyay

et al. 2009

J Assist Reprod Genet

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Purpose Letrozole, though reported to be an effective ovulation inducing agent, warrants larger randomized trials. The purpose of this study is to compare the efficacy of letrozole with that of rFSH and clomiphene citrate(CC)/rFSH for ovarian stimulation in IUI cycles. Methods Randomized, prospective, single-blinded clinical trial. 1387 PCOS women after CC failure were randomized into three groups: Group A received letrozole, Group B received CC with two doses rFSH and Group C received continuous rFSH day 2 onwards until hCG injection. Results Group A, B and C had an ovulation rate of 79.30%, 56.95% and 89.89% and cycle cancellation rate of 20.70%, 43.05% and 10.11%, respectively. Pregnancy rates in Group A, B and C were 23.39%, 14.35% and 17.92%, while the miscarriage rates were 13.80%, 16.67% and 14.52%, respectively. Conclusion Letrozole appears to be a suitable ovulation inducing agent in PCOS women with CC failure and is found to be most effective when baseline estradiol level >60 pg/ml.

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Section: Discussionmentioning

confidence: 49%

“…However, 20-25% of the women are resistant to CC and fail to ovulate [2]. In such cases, the traditional option is to administer gonadotropins, though it is associated with an enhanced risk of multiple pregnancies and ovarian hyperstimulation [3].…”

Section: Introductionmentioning

confidence: 99%

Comparison of letrozole with continuous gonadotropins and clomiphene-gonadotropin combination for ovulation induction in 1387 PCOS women after clomiphene citrate failure: a randomized prospective clinical trial

Ganesh

Goswami

Chattopadhyay

et al. 2009

J Assist Reprod Genet

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“…Whereas response to CC is less likely with elevated BMI, amenorrhea, and increased age, significant differences between letrozole responders and nonresponders were not noted for any evaluated measure. This apparent lack of predictive factors for letrozole suggests utility in CC-resistant patients since its efficacy is not limited to specific patient characteristics (105). The safety of letrozole has elaborated a vivid discussion.…”

Section: Third-generation Aromatase Inhibitorsmentioning

confidence: 99%

Management of Women with Clomifene Citrate Resistant Polycystic Ovary Syndrome – An Evidence Based Approach

Hashim¹

2012

Polycystic Ovary Syndrome

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“…3 In such cases, the traditional alternative is to administer gonadotropins; however, it is associated with an enhanced risk of multiple pregnancies and ovarian hyperstimulation. 4 Gonadotropins (FSH/hMG) used in combination with CC decrease the dose required for optimum stimulation and make it more cost-effective in women who fail to react to CC treatment.…”

Section: Introductionmentioning

confidence: 99%

“…2 However, 20-25% of the women are failing to ovulate due to CC resistant. 3 In such cases, the traditional alternative is to administer gonadotropins; however, it is associated with an enhanced risk of multiple pregnancies and ovarian hyperstimulation.…”

Section: Introductionmentioning

confidence: 99%

Use of letrozole versus clomiphene citrate combined with gonadotropins for ovulation induction in infertile women with polycystic ovary syndrome: a pilot study

Athwal¹,

Chakravorty²,

Sur³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONIt is now well known that polycystic ovary syndrome (PCOS) is among the most common endocrine disorders in women of reproductive age, with an estimated prevalence of 5%-10% of the general population, and by far the most common cause of an-ovulatory infertility. 1 Clomiphene citrate has been the most widely used drug for the treatment of infertility.2 However, 20-25% of the women are failing to ovulate due to CC resistant. 3 In such cases, the traditional alternative is to administer gonadotropins; however, it is associated with an enhanced risk of multiple pregnancies and ovarian hyperstimulation. 4 Gonadotropins (FSH/hMG) used in combination with CC decrease the dose required for optimum stimulation and make it more cost-effective in women who fail to react to CC treatment. 5 As of late, aromatase inhibitor has been explored as a potential ABSTRACT Background: The aim of the study was to evaluate the efficacy of letrozole and clomiphene citrate (CC) in gonadotropin-combined for ovulation stimulation in women with polycystic ovary syndrome (PCOS). It was a prospective pilot study. Methods: This prospective trial included 124 patients of infertile women with PCOS. Letrozole dose of 5 mg/day (n = 65) or a CC dose of 100 mg/day (n = 59) was given on day 3 to day 7 of the menstrual cycle, combined with gonadotropin i.e. follicle stimulating hormone (FSH) at a dose 75 IU every day starting on day 7 and continued to day 9. Main outcome measures were occurrence of ovulation, number of mature follicles, serum estradiol (E2) and endometrial thicknesses on the day of human chorionic gonadotropin (hCG), and pregnancy rates. Results: The clinical profile including mean age, duration of infertility, BMI, baseline FSH, LH and E2 of patients belonging to both groups were comparable. The numbers of mature follicles (4.3±0.3 vs. 2.9±0.7) were significantly higher in letrozole+FSH group. Serum E2 levels on the day of hCG (301.78±85.7 vs. 464.7±72.9 pg/mL) were significantly lower in the letrozole+FSH group. Significant differences were found in endometrial thickness measured on the day of hCG in letrozole+FSH group (p=<0.0001). The rate of ovulation was higher in letrozole+FSH group and it was marginally statistically significant (p=0.040). The rate of pregnancy was slightly greater in the letrozole+FSH group (17.85% versus 13.33%), although not statistically significant. Conclusions: Letrozole in combination with FSH appears to be a suitable ovulation inducing agent versus CC with FSH in PCOS. This combination may be more appropriate in patients who are particularly sensitive to gonadotropin.

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Letrozole induction of ovulation in women with clomiphene citrate–resistant polycystic ovary syndrome may not depend on the period of infertility, the body mass index, or the luteinizing hormone/follicle-stimulating hormone ratio

Cited by 62 publications

References 11 publications

Comparison of letrozole with continuous gonadotropins and clomiphene-gonadotropin combination for ovulation induction in 1387 PCOS women after clomiphene citrate failure: a randomized prospective clinical trial

Comparison of letrozole with continuous gonadotropins and clomiphene-gonadotropin combination for ovulation induction in 1387 PCOS women after clomiphene citrate failure: a randomized prospective clinical trial

Management of Women with Clomifene Citrate Resistant Polycystic Ovary Syndrome – An Evidence Based Approach

Use of letrozole versus clomiphene citrate combined with gonadotropins for ovulation induction in infertile women with polycystic ovary syndrome: a pilot study

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