Letrozole stimulation in endometrial preparation for cryopreserved–thawed embryo transfer in women with polycystic ovarian syndrome: A pilot study

Hu, Yan-Jun; Chen, Yuezhou; Zhu, Yimin; Huang, He‐Feng

doi:10.1111/cen.12280

Cited by 42 publications

(52 citation statements)

References 32 publications

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“…4), MR (OR 1.02, 95 % CI: 0.60-1.74) and EMT (WMD 0.01, 95 % CI: − 1.69 to 1.70) (▶ Table 2). A statistically higher OPR (OR 4.50, 95 % CI: 1.62-12.48) was reported for the letrozole group in one study [24], while the other study reported a statistically lower LBR (OR 0.67, 95 % CI: 0.52-0.86) [25] (▶ Fig. 5, Table 2).…”

Section: Letrozole Versus Hmgmentioning

confidence: 80%

“…It is also noteworthy that only two articles clearly stated that their study populations were PCOS patients [24,28], while the other articles did not clearly differentiate between patients. This meant that we were unable to perform subgroup analyses for women with or without a PCOS diagnosis.…”

Section: Letrozole Versus Acmentioning

confidence: 95%

“…3), OPR (OR 1.24, 95 % CI: 0.95-1.63), MR (OR 0.75, 95 % CI: 0.51-1.10), BDR (OR 1.39, 95 % CI: 0.84-2.28) and EMT (WMD 0.57, 95 % CI: − 0.04 to 1.18) (▶ Table 2). HMG was added to the letrozole cycle in 3 studies [23,24,28], while no HMG was administered in the letrozole arm in 5 studies [22, 25 -27, 29]. When letrozole plus HMG was compared with AC, there was no statistically significant difference in CPR (OR 1.30, 95 % CI: 0.80-2.12) (▶ Fig.…”

Section: Letrozole Versus Acmentioning

confidence: 99%

“…Two studies representing 1638 cycles were included to compare outcomes for letrozole with those for HMG [24,25]. There were no evident differences between the groups with regard to CPR (OR 1.46, 95 % CI: 0.29-7.21) (▶ Fig.…”

Section: Letrozole Versus Hmgmentioning

confidence: 99%

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Pregnancy Outcomes Following Letrozole Use in Frozen-thawed Embryo Transfer Cycles: A Systematic Review and Meta-analysis

Chen

Shen

et al. 2020

Geburtshilfe Frauenheilkd

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While widely used for ovulation induction in assisted reproductive technology, the clinical efficacy of letrozole for endometrial preparation prior to frozen-thawed embryo transfer (FET) cycles remains yet to be elucidated. We performed a meta-analysis to compare pregnancy outcomes after letrozole use with those of other endometrial preparation protocols in patients undergoing FET. PubMed, Scopus, Embase and the Cochrane Library were searched for eligible studies. Clinical pregnancy rate (CPR), live birth rate (LBR) and birth defect rate (BDR) were analysed using odds ratio (OR) and 95% confidence interval (CI). A total of 10 studies representing 75 968 FET cycles were included. Comparable CPR and LBR were observed when comparing letrozole administration with natural cycle (OR 1.24, 95% CI: 0.69 – 2.24; OR 1.18, 95% CI: 0.60 – 2.32), artificial cycle (OR 1.46, 95% CI: 0.87 – 2.44; OR 1.39, 95% CI: 0.77 – 2.52), and artificial cycle with gonadotropin-releasing hormone agonist suppression (OR 1.11, 95% CI: 0.78 – 1.59; OR 1.18, 95% CI: 0.82 – 1.68). Pooled results of the limited studies comparing letrozole with human menopausal gonadotropin demonstrated a similar CPR between groups (OR 1.46, 95% CI: 0.29 – 7.21, two studies), but the letrozole group had a statistically lower LBR (OR 0.67, 95% CI: 0.52 – 0.86, one study). No increased BDR was observed in the letrozole group compared to natural cycles or artificial cycles (OR 0.98, 95% CI: 0.60 – 1.61; OR 1.39, 95% CI; 0.84 – 2.28). This pooled analysis supports the use of letrozole as an efficacious and safe alternative to mainstream regimens for endometrial preparation in FET cycles.

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Section: Letrozole Versus Hmgmentioning

confidence: 80%

Section: Letrozole Versus Acmentioning

confidence: 95%

Section: Letrozole Versus Acmentioning

confidence: 99%

Section: Letrozole Versus Hmgmentioning

confidence: 99%

See 2 more Smart Citations

Pregnancy Outcomes Following Letrozole Use in Frozen-thawed Embryo Transfer Cycles: A Systematic Review and Meta-analysis

Chen

Shen

et al. 2020

Geburtshilfe Frauenheilkd

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“…[87][88][89][90] Letrozole FER requires fewer days of medication than medicated FER and small retrospective studies suggest at least equivalent clinical pregnancy rates. [91][92][93] However, more research is required.…”

Section: Ovarian Stimulation Cyclesmentioning

confidence: 99%

The role of frozen–thawed embryo replacement cycles in assisted conception

Noble

Child

2019

The Obstetric & Gynaecologis

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Recent years have seen a dramatic rise in the number of frozenthawed embryo replacement (FER) cycles. Improved embryo cryopreservation techniques have resulted in outcomes for FER that are similar to fresh embryo transfer. FER maximises the cumulative live-birth rate of a fresh in vitro fertilisation (IVF) cycle by using excess embryos and encourages a policy of single embryo transfer; this has contributed to a fall in the multiple pregnancy rate associated with IVF. Freezing all suitable embryos in a fresh cycle reduces the risk of ovarian hyperstimulation syndrome. The endometrium is prepared for FER by a natural or medicated protocol; the optimum method is unknown. Learning objectives To appreciate the importance of FER in IVF practice. To understand the current debate surrounding fresh versus frozen IVF. To understand the indications for, and methods of, embryo cryopreservation. To understand the commonly used methods of endometrial preparation for FER. To be able to date an FER pregnancy. Ethical issues Funding from the National Health Service (NHS) for embryo storage and FER varies widely across the UK; where funding is limited, this can result in viable embryos being discarded. When an embryo is created by a couple, the consent of both partners is required before transferring the embryo.

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Endometrial preparation protocol of the frozen-thawed embryo transfer in patients with polycystic ovary syndrome

et al. 2014

Arch Gynecol Obstet

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The mean endometrial thickness, clinical pregnancy rate, ongoing pregnancy rate, live birth rate and implantation rate were similar in artificial and stimulated cycle for endometrial preparation prior to FET in PCOS. It was fine to add vaginal 17-β oestradiol to stimulated cycle when necessary. However, stimulated cycles had a significantly higher cancelled cycle rate. We should follow the principles of individualization, securitization and optimization in endometrial preparation of the FET in patients with PCOS.

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Letrozole stimulation in endometrial preparation for cryopreserved–thawed embryo transfer in women with polycystic ovarian syndrome: A pilot study

Abstract: Using letrozole stimulation in endometrial preparation for cryopreserved-thawed embryo transfer in patients with PCOS may be associated with better outcomes than using hormonal manipulation or hMG stimulation.

Cited by 42 publications

References 32 publications

Pregnancy Outcomes Following Letrozole Use in Frozen-thawed Embryo Transfer Cycles: A Systematic Review and Meta-analysis

Pregnancy Outcomes Following Letrozole Use in Frozen-thawed Embryo Transfer Cycles: A Systematic Review and Meta-analysis

The role of frozen–thawed embryo replacement cycles in assisted conception

Endometrial preparation protocol of the frozen-thawed embryo transfer in patients with polycystic ovary syndrome

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