No increased risk of major congenital anomalies or adverse pregnancy or neonatal outcomes following letrozole use in assisted reproductive technology

Tatsumi, Takayuki; Jwa, Seung Chik; Kuwahara, Akira; Irahara, Minoru; Kubota, Toshiro; Saito, Hidekazu

doi:10.1093/humrep/dew280

Cited by 39 publications

(44 citation statements)

References 23 publications

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“…Although an association between the use of letrozole for infertility treatment and congenital anomalies was reported in a relatively small number of pregnancies, such an association was rejected in recent studies . In general, letrozole 2.5 or 5 mg per day was used for ovarian stimulation .…”

Section: Discussionmentioning

confidence: 99%

“…Although an association between the use of letrozole for infertility treatment and congenital anomalies was reported in a relatively small number of pregnancies, 19 such an association was rejected in recent studies. [20][21][22] In general, letrozole 2.5 or 5 mg per day was used for ovarian stimulation. 5,7 Although the difference in serum peak E2 level did not reach statistical significance, there was a trend in that serum peak E2 level was lower in the 5 mg compared to 2.5 mg group.…”

Section: Fps (N = 29) Lps (N = 21) Pmentioning

confidence: 99%

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Random‐start ovarian stimulation with aromatase inhibitor for fertility preservation in women with Japanese breast cancer

Nakasuji

Kawai

Ishikawa

et al. 2019

Reprod Medicine & Biology

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Purpose Fertility preservation is an important issue for young cancer patients. Random‐start controlled ovarian stimulation and double ovarian stimulation have been proposed for efficient oocyte retrieval within the limited time before cancer therapy. We aimed to clarify the efficacy of these new protocols within the Japanese population. Methods We performed a retrospective observational study at a multicenter from February 2012 to August 2017. The study entailed 50 cycles with 34 patients who underwent fertility preservation due to breast cancer. Follicular phase or luteal phase ovarian stimulation with aromatase inhibitor was performed. A second ovarian stimulation was started with or without waiting until the next menstruation. We measured the number of retrieved oocytes and cryopreserved oocytes/embryos, the ratio of mature oocytes, and the fertilization rate. Results The numbers of retrieved oocytes and frozen oocytes/embryos were not significantly different between follicular phase and luteal phase ovarian stimulation. The number of retrieved oocytes was not reduced at the second ovum pick up compared to the first ovum pick up in the double ovarian stimulation. Conclusions Random‐start controlled ovarian stimulation and double ovarian stimulation with aromatase inhibitor for breast cancer patients were effective protocols for retrieving a greater number of oocytes within the limited time.

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Section: Discussionmentioning

confidence: 99%

Section: Fps (N = 29) Lps (N = 21) Pmentioning

confidence: 99%

Random‐start ovarian stimulation with aromatase inhibitor for fertility preservation in women with Japanese breast cancer

Nakasuji

Kawai

Ishikawa

et al. 2019

Reprod Medicine & Biology

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“…The data that were reported at the ASRM's annual meeting in 2005 suggested that letrozole is teratogenic; however, in a RCT that used letrozole for 900 women with unexplained fertility, there was no increase in the rate of major anomalies . A study of infertile Japanese women that compared the data between 3136 natural cycles and 792 letrozole‐induced cycles, both of which were associated with fresh, single‐embryo transfer and resulted in a clinical pregnancy, revealed that the risk of miscarriage was, in fact, significantly lower in the letrozole group, while the two groups were equal in terms of major congenital anomalies and the risk for any specific organ system …”

Section: Recent Issues In Assisted Reproductive Technology For Fertilmentioning

confidence: 99%

“…35 A study of infertile Japanese women that compared the data between 3136 natural cycles and 792 letrozole-induced cycles, both of which were associated with fresh, single-embryo transfer and resulted in a clinical pregnancy, revealed that the risk of miscarriage was, in fact, significantly lower in the letrozole group, while the two groups were equal in terms of major congenital anomalies and the risk for any specific organ system. 36 Few studies have compared the treatment outcomes between controlled ovarian stimulation combined with letrozole and conventional controlled ovarian stimulation. In one such study that compared 142 cycles, in which letrozole was combined with a GnRH antagonist protocol, to 97 cycles conducted with a typical GnRH antagonist protocol, the number of oocytes that was retrieved was significantly lower in the former group despite equal doses of FSH preparations.…”

Section: Aromatase Inhibitors For Estrogen-dependent Malignanciesmentioning

confidence: 99%

Recent advances in oncofertility care worldwide and in Japan

Takai

2018

Reprod Medicine & Biology

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BackgroundOncofertility is a crucial facet of cancer supportive care. The publication of guidelines for the cryopreservation of oocytes and ovarian tissue is becoming increasingly prevalent in Japan and an updated overview is necessary.MethodsIn order to provide an updated overview of oncofertility care, original research and review articles were searched from the PubMed database and compared in order to present clinical care in Japan.ResultsIn Western countries, various methods for ovarian stimulation, such as the combined use of aromatase inhibitors and random‐start protocols, have been reported. Although ovarian tissue cryopreservation, mainly performed via the slow‐freezing method, also has yielded >100 live births, the optimal indications and procedures for the auto‐transplantation of cryopreserved tissue have been under investigation. In Japan, however, vitrification is prevalent for ovarian tissue cryopreservation, although its efficacy has not yet been established. The quality of network systems for providing oncofertility care in Japan varies greatly, based on the region.ConclusionThere remain many issues in the optimization of oncofertility care in Japan. Along with the regional oncofertility networks, the creation of “oncofertility navigators” from healthcare providers who are familiar with oncofertility, such as nurses, psychologists, and embryologists, could be useful for supplementing oncofertility care coordination, overcoming the issues in individual regions.

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“…Отмечено также, что применение летрозола в программах ВРТ обеспечивает сни-жение риска самопроизвольного прерывания беременности, не увеличивает риски серьезных врожденных аномалий и неблагоприятных пе-ринатальных исходов [58][59][60].…”

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Aromatase inhibitors in “poor” ovarian responders undergoing in vitro fertilization

Merkulova

Игоревна²

2017

Z.akus.zen.bolezn

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■ Проблема «слабого» ответа яичников на стимуляцию существует с момента начала широкого применения экс-тракорпорального оплодотворения (ЭКО) с целью лечения бесплодия. От 9 до 25 % циклов ЭКО сопровождается недостаточной ответной реакцией яичников на вводимые извне гонадотропины. В опубликованной за последние годы литературе описано большое количество методов преодоления «слабого» ответа, но результаты исследо-вания их эффективности противоречивы, а единого подхода к выбору оптимального алгоритма лечения нет. В статье описываются возможные пути реализации лечебного действия ингибиторов ароматазы у пациенток со «слабым» ответом на стимуляцию. ■ Ключевые слова: стимуляция овуляции; ЭКО; «слабый» ответ; ингибиторы ароматазы. AROMATASE INHIBITORS IN "POOR" OVARIAN RESPONDERS UNDERGOING IN VITRO FERTILIZATION © A.I. MerkulovaSt Petersburg State University, Saint Petersburg, Russia ■ Since the IVF treatment expands worldwide, it has become apparent that a proportion of women responds suboptimally to controlled ovarian stimulation with exogenous gonadotrophins. There is still no consensus on the ideal controlled ovarian stimulation protocol for patients with "poor" ovarian response. Many strategies have been studied. However, no compelling advantage for one treatment protocol over another has been identified. The addition of aromatase inhibitors in "poor" responders stimulation protocols is described in this article.■ Keywords: ovarian stimulation; IVF; poor ovarian response; aromatase inhibitors.По мере того как экстракорпоральное опло-дотворение (ЭКО), как метод лечения беспло-дия, получало все более широкое распростра-нение, все более очевидным становилось то, что далеко не во всех случаях стимуляции супер-овуляции ответ яичников на вводимые извне гонадотропины является оптимальным [1, 2]. По различным данным, частота встречаемости этой проблемы в программах вспомогательных репродуктивных технологий (ВРТ) составляет от 9 до 25 %, и с каждым годом она увеличива-ется [3, 4]. В 2010 г. в Болонье рабочей группой Евро-пейского общества репродукции человека и эм-бриологии было дано определение «слабому» ответу яичников на стимуляцию и сформу-лированы критерии, позволяющие его про-гнозировать. До публикации этого консенсу-са в 2011 г. проблема недостаточного ответа яичников в программах ВРТ была очевидна, но не конкретизирована в диагностическом аспекте.Согласно Болонским критериям «слабого» ответа яичников на стимуляцию, применение этого определения правомочно при соблюде-нии двух из трех условий [5]: 1) возраст женщины 40 и более лет или нали-чие других факторов риска «слабого» ответа на стимуляцию; 2) сниженный овариальный резерв (число ан-тральных фолликулов < 5-7; антимюллеров гормон (АМГ) < 0,5-1,1 нг/мл); 3) предшествующий «слабый» ответ яичников на стимуляцию при использовании адекват-ных доз гонадотропинов (3 и менее получен-ных ооцитов или отмена протокола в связи с отсутствием ответа яичников на проводи-мую стимуляцию).

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No increased risk of major congenital anomalies or adverse pregnancy or neonatal outcomes following letrozole use in assisted reproductive technology

Abstract: Not applicable.

Cited by 39 publications

References 23 publications

Random‐start ovarian stimulation with aromatase inhibitor for fertility preservation in women with Japanese breast cancer

Random‐start ovarian stimulation with aromatase inhibitor for fertility preservation in women with Japanese breast cancer

Recent advances in oncofertility care worldwide and in Japan

Aromatase inhibitors in “poor” ovarian responders undergoing in vitro fertilization

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