scholarly journals Dosage Optimization for Letrozole Treatment in Clomiphene-Resistant Patients with Polycystic Ovary Syndrome: A Prospective Interventional Study

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Elham Rahmani ◽  
Shahnaz Ahmadi ◽  
Niloofar Motamed ◽  
Hesam_Oddin Maneshi
Keyword(s):  
Pregnancy Rate ◽  
Polycystic Ovary ◽  
Clinical Pregnancy ◽  
Medical Sciences ◽  
Interventional Study ◽  
Ovary Syndrome ◽  
Number Of Patients ◽  
Letrozole Treatment ◽  
Number Of Cycles ◽  
Infertile Patients

Objective. Dose adjustment for induction of ovulation is one of the most important problem.Methods. In a prospective interventional study, 44 clomiphene-resistant infertile patients (113 cycles) were selected from the Abolfazl Infertility Clinic of Bushehr University of Medical Sciences. Letrozole was given orally in a dose of 2.5 mg, 5 mg, and 7.5 mg, respectively. If the patient displayed no response, the dosage was increased.Results. In this patients ovulation occurred in 50 cycles (44.24%), clinical pregnancy rate according to number of cycles was 23.89% (27 of 113 cycles) and according to the number of patients was 61.36% (27 of 44 patients). In the 2.5, 5, and 7.5 groups, follicles occurred in 22.9%, 42.1%, and 85.18% of cycles, and pregnancy rate was 14.58%, 28.94% and, 33.33%, respectively.Conclusions. It is better to administer Letrozole at a lower dosage to prevent complications and increase the dose based on sonographic results antral follicular count, anti-Müllerian hormone, LH/FSH, and estradiol.

scholarly journals Using Letrozole Cotreatment With Progestin-Primed Ovarian Stimulation In Women With Polycystic Ovary Syndrome Treated For IVF

2021 ◽  
Author(s):  
Yali Liu ◽  
Jiaying Lin ◽  
Li Chen ◽  
Xiaoyan Mao ◽  
Li Wang ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Ovarian Stimulation ◽  
Polycystic Ovary ◽  
Implantation Rate ◽  
Clinical Pregnancy ◽  
Control Group ◽  
Miscarriage Rate ◽  
Ovary Syndrome ◽  
Premature Lh Surge ◽  
Pituitary Suppression

Abstract Background: Women with polycystic ovary syndrome (PCOS) often experience poor oocyte quality and a high risk of ovarian hyperstimulation syndrome (OHSS) when treated with controlled ovarian stimulation (COS) in vitro fertilization (IVF). Progestin-primed ovarian stimulation (PPOS) shows good potential to compete with conventional protocols in women with PCOS. However, it always accompanied by increased pituitary suppression and gonadotropin consumption. Letrozole (LE) has the ability to increase luteinizing hormone (LH) levels and appears to have the potential to alleviate pituitary inhibition during COS in women with PCOS. A retrospective cohort trial was performed to evaluate the efficacy of PPOS with or without letrozole in infertile women with PCOS.Methods: This retrospective cohort study included 448 women with PCOS who underwent COS with human menopausal gonadotropin (hMG) and medroxyprogesterone acetate (MPA) (n=224) or hMG and MPA cotreatment with LE (n=224) from January 2018 to March 2021. Baseline characteristics of the two groups were balanced with propensity score matching using the nearest neighbour random matching algorithm at a ratio of 1:1. The primary outcome measure was the implantation rate. The secondary outcomes were the endocrinological profiles, gonadotropin dose and duration, number of oocytes retrieved and viable embryos, clinical pregnancy rate, miscarriage rate and ectopic pregnancy rates.Result(s): The implantation rate was significantly higher in the study group than that in the control group (42.22% vs. 34.69%, P < 0.05). Compared with the control group，the study group had a higher LH concentration on the trigger day (3.85±3.6 mIU/ml vs. 2.44±1.71 mIU/ml, P < 0.01), but there was no case of premature LH surge or OHSS in both groups. The consumption of gonadotropin, the number of oocytes retrieved and viable embryos were similar between the two groups. Additionally, no difference was found in the clinical pregnancy rate, miscarriage rate or ectopic pregnancy rate.Conclusion(s): This study shows that LE administration in the PPOS protocol was feasible to improve the implantation rate and alleviate profound pituitary suppression from progestin administration without interfering with its premature LH surge blockade effect but with a non-significant reduction in gonadotropin consumption in women with PCOS undergoing IVF treatment.

Prevalence of polycystic ovary syndrome in infertile patients in Albania

2013 ◽  
Author(s):  
Mimoza Dollenga ◽  
Thanas Fureraj ◽  
Kosta Dhima ◽  
Edmond Bizbiqi ◽  
Artan Simaku
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
Infertile Patients

scholarly journals Efficacy of letrozole versus clomiphene citrate for infertile women with polycystic ovary syndrome

2021 ◽  
Vol 10 (8) ◽  
pp. 2944
Author(s):  
Sinan S. Ay ◽  
Özer Birge ◽  
Mehmet S. Bakır ◽  
Ayşe E. Yumru
Keyword(s):  
Aromatase Inhibitor ◽  
Ovulation Induction ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Ovary Syndrome ◽  
Infertile Women ◽  
Appropriate Treatment ◽  
The Mean ◽  
Infertility Patients ◽  
Infertile Patients

Background: The aim was to compare ovulation induction protocols in anovulatory patients, who make up a significant percentage of infertility patients, and to determine the most appropriate treatment for patients in the clinic based on the findings.Methods: The effectiveness of clomiphene citrate (CC) and letrozole (aromatase inhibitor) in ovulation induction treatments were retrospectively compared in patients who applied for infertility in the last 5 years and were found to be anovulatory. 20 of these patients were being treated with clomiphene citrate, while the 18 were being treated with letrozole.Results: The study included a total of 38 anovulatory infertile patients. The mean age of the patients was found to be 29.3. When the endometrial thicknesses (ET) after the treatment were compared, the first group's mean EC was 6.1, while that of the second group was 9.05. The endometrial thicknesses measured after the treatments were found to be significantly different, which were consistent with other studies in the literature. Post-treatment ovulation responses were similar with 55% in both groups. In the evaluation of pregnancy outcomes, 20% of pregnancy was achieved in the first group and 33% in the second group.Conclusions: The use of letrozole, an aromatase inhibitor, may be suggested as an alternative to CC in the ovulation induction protocol in our clinical practice, particularly in obese patients.

scholarly journals Impact of Short-Term Isoflavone Intervention in Polycystic Ovary Syndrome (PCOS) Patients on Microbiota Composition and Metagenomics

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1622 ◽  
Author(s):  
Christoph Haudum ◽  
Lisa Lindheim ◽  
Angelo Ascani ◽  
Christian Trummer ◽  
Angela Horvath ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Biochemical Characterization ◽  
Polycystic Ovary ◽  
Alpha Diversity ◽  
Intestinal Bacteria ◽  
Reproductive Age ◽  
Control Group ◽  
Interventional Study ◽  
Ovary Syndrome ◽  
Receptor Modulator

Background: Polycystic ovary syndrome (PCOS) affects 5–20% of women of reproductive age worldwide and is associated with disorders of glucose metabolism. Hormone and metabolic signaling may be influenced by phytoestrogens, such as isoflavones. Their endocrine effects may modify symptom penetrance in PCOS. Equol is one of the most active isoflavone metabolites, produced by intestinal bacteria, and acts as a selective estrogen receptor modulator. Method: In this interventional study of clinical and biochemical characterization, urine isoflavone levels were measured in PCOS and control women before and three days after a defined isoflavone intervention via soy milk. In this interventional study, bacterial equol production was evaluated using the log(equol: daidzein ratio) and microbiome, metabolic, and predicted metagenome analyses were performed. Results: After isoflavone intervention, predicted stool metagenomic pathways, microbial alpha diversity, and glucose homeostasis in PCOS improved resembling the profile of the control group at baseline. In the whole cohort, larger equol production was associated with lower androgen as well as fertility markers. Conclusion: The dynamics in our metabolic, microbiome, and predicted metagenomic profiles underline the importance of external phytohormones on PCOS characteristics and a potential therapeutic approach or prebiotic in the future.

Low-dose metformin improves pregnancy rate in IVF repeaters without polycystic ovary syndrome: its indication and mechanism

2010 ◽  
Vol 94 (4) ◽  
pp. S29
Author(s):  
M. Jinno ◽  
A. Watanabe ◽  
N. Eguchi ◽  
N. Hatakeyama ◽  
J. Hirohama ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Pregnancy Rate ◽  
Low Dose ◽  
Polycystic Ovary ◽  
Ovary Syndrome

scholarly journals Role of Anti-mullerian Hormone (AMH), As A Prediction of Clinical Pregnancy Outcome in Women with Polycystic Ovarian Syndrome with Sub Fertility

2018 ◽  
Vol 9 (1) ◽  
pp. 3-5
Author(s):  
Ashia Khatun ◽  
Afroza Kutubi ◽  
Khairun Nahar ◽  
Israt Jahan ◽  
Hasina Begum ◽  
...  
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Polycystic Ovary ◽  
Clinical Pregnancy ◽  
Age Group ◽  
Serum Samples ◽  
Ovary Syndrome ◽  
Randomized Sampling ◽  
Ovarian Syndrome ◽  
Good Linear Correlation

Background: Anti-mullerian hormone (AMH) in largely expressed throughout folliculogenisis (by granulosa cells in ovarian follicles) but highest in pre-antral and small antral steges (<4mm) drameter of development.Objective: To analyse the usefulness of plasma anti-mullerian hormone (AMH) measurement as a test for assessing ovarian reserve in Polycystic ovary syndrome with sub fertility,Methodology: Women with PCOS and sub fertility, were included in this study with age group 18-35yrs. This Prospetive cohort study done in 30 cases in ShSMC with purposive randomized sampling, from January 2015 to December 2015. Serum, plasma & for evaluation of PCOS, preferably TV-USG was done.Result: In this study we analyze 30 serum samples from patient aged between 18-35 years and transvaginal ultrasonography was done simultaneously. Mean age group of my patient was 25.2±4.7 years which correlates with AMH level in PCOS which is statistically significant (p<0.001). Mean level of AMH is 5.7±4.9 mg/ml which is also correlate with transvaginal USG scan with the feature of PCOS (p<.0.001). More than 50% woman presents with features of subfertility with PCOS and 46.7% are normal ovaries. Mean menstrual day 7.6 (4-12 days) which have a good linear correlation with irregularities of menstrual cycle and PCOS (p<0.05).Conclusion: To conclude AMH appears to have a major inhibiting role during folliculogenesis, which may contribute to anovulation in PCOS. The reason for the raised AMH in PCOS may give clues as to the mechanism os anovulation.J Shaheed Suhrawardy Med Coll, June 2017, Vol.9(1); 3-5

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