Comparative study of efficacy between metformin and aromatase inhibitor (letrozole) plus metformin as the medication for ovulation induction, achievement of pregnancy and live birth in Asian women with polycystic ovarian syndrome: A prospective trial

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Samsad Jahan ◽  
Samira Humaira Habib ◽  
Mohammed Sakandar Hyet Khan ◽  
Akter Jahan ◽  
Farzana Sharminr ◽  
...  
Keyword(s):  
Comparative Study ◽  
Aromatase Inhibitor ◽  
Live Birth ◽  
Ovulation Induction ◽  
Polycystic Ovarian Syndrome ◽  
Prospective Trial ◽  
Asian Women ◽  
Ovarian Syndrome

scholarly journals A study of comparison of effectiveness of letrozole (5mg) versus clomephene citrate (100 mg) for ovulation induction among infertile women

2021 ◽  
Vol 8 (4) ◽  
pp. 553-558
Author(s):  
Manish R Pandya ◽  
Khushbu Patel
Keyword(s):  
Aromatase Inhibitor ◽  
Ovulation Induction ◽  
Polycystic Ovarian Syndrome ◽  
Clomiphene Citrate ◽  
Estradiol Valerate ◽  
Infertile Women ◽  
Group A ◽  
Group B ◽  
Ovarian Syndrome ◽  
Anovulatory Infertility

Clomiphene citrate has been traditionally used as the drug of the choice for treatment of women with anovulatory infertility. In the last decade, an aromatase inhibitor, letrozole has emerged as an alternative ovulation induction agent among anovulatory women with polycystic ovarian syndrome. Letrozole has a definitive role in anovulatory women who have not responded to the clomiphene citrate therapy is confirmed by literatures. Anovulatory dysfunction is a common problem and is responsible for about 40% of female infertility and among causes; PCOS (polycystic ovarian syndrome) is the leading cause. Clomiphene citrate is considered as the drug of choice for the first line treatment of anovulatory dysfunction for a variety of reasons. Clomiphene citrate has some side effects like multi-follicular development and cyst formation and resistance of clomiphene are areas of concern and desire for an effective alternative persists.An aromatase inhibitor, letrozole, was introduced into infertility practice in the year 2000 and is regarded as a second line option, particularly in women with clomiphene resistance, and it has found acceptance in various clinical situations and the indications for use have expanded., To compare the efficacy of letrozole and clomiphene citrate (CC) for ovulation induction in infertile women. The study included 100 women presented with anovulatory infertility. The infertile women were divided into 2 groups of 50: Group A received 100 mg Clomiphene Citrate from day 3 to day 5 of menstruation and Estradiol Valerate 4 mg on the 12 day of menstruation until 16 day of menstruation; Group B treated by 5 mg Letrozole from day 3 to day 5 of the menstruation and as Group A, Estradiol Valerate 4 mg on the 12 day of menstruation until 16 day of menstruation given to Group B, with visits to determine ovulation and pregnancy, followed by tracking of pregnancies. Participants were of 20 to 39 years age, had normal uterine cavity and had a male partner with a sperm concentration of at least 14 million per millilitre; and during the study the women and their partners agreed to have regular intercourse with the intent of conception. The live birth during the treatment period was the primary outcome. Women who received letrozole had more cumulative live births than those women who had received clomiphene citrate (36 out of 50 [72%] vs. 28 out of 50 [56%]), without significant differences in overall congenital anomalies, there were no congenital anomalies. With letrozole as compared to clomiphene the cumulative ovulation rate was higher. Higher incidence of hot flushes was associated with a clomiphene, and letrozole was associated with fatigue and dizziness. Rates of other adverse effects were almost similar among these 2 groups. A significant difference in the follicular and endometrial development was evident among these 2 groups. As compared to with clomiphene, an aromatase inhibitor, letrozole was associated with higher live-birth and ovulation rates among infertile women. The results of the study demonstrated letrozole to be superior to clomiphene citrate in the maintenance of endometrial thickness.

scholarly journals To Study the Effect on Fertility Outcome by Gonadotropins vs Laparoscopic Ovarian Drilling in Clomiphene-resistant Cases of Polycystic Ovarian Syndrome

2017 ◽  
Vol 9 (4) ◽  
pp. 336-340 ◽  
Author(s):  
Richa Singh ◽  
Meenal Jain ◽  
Poonam Yadav ◽  
Sarvesh Awasthi ◽  
Pallavi Raj
Keyword(s):  
Statistical Analysis ◽  
Ovulation Induction ◽  
Polycystic Ovarian Syndrome ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Reproductive Age ◽  
Multiple Pregnancies ◽  
Laparoscopic Ovarian Drilling ◽  
Ovarian Drilling ◽  
Ovarian Syndrome

ABSTRACT Introduction The polycystic ovary syndrome (PCOS) is the most common condition associated with chronic anovulation affecting 4 to 6% of reproductive age women. Aim To compare the effectiveness of laparoscopic ovarian drilling (LOD) for ovulation induction with gonadotropins in clomiphene-resistant PCOS in terms of ovulation, pregnancy, live birth, abortion, multiple pregnancies, and complication like ovarian hyperstimulation syndrome (OHSS). Setting and design A prospective hospital-based randomized trial. Materials and methods It was a prospective study, which was carried out from January 2012 to May 2015. Totally, 89 women were evaluated in the study, out of which 44 women were in gonadotropin group and 45 were in LOD group. Statistical analysis Standard statistical analysis was done and significance of difference in results was tested by chi-square test. Results Ovulation rate in gonadotropin group was 75.0% at 6 months, whereas in LOD group, it was 20% at 3 months and was increased up to 66.66% after addition of clomiphene citrate and gonadotropin. The primary outcome in terms of pregnancy in gonadotropin group was 45.45% after 6 cycles and in LOD group was 11.11% after 3 cycles and 40.00% after 6 cycles with supplementation of clomiphene citrate and gonadotropin. Conclusion The ongoing pregnancy rate from ovulation induction with LOD alone was significantly less but if supplemented by clomiphene citrate and gonadotropin, it seems equivalent to ovulation induction with gonadotropin, but the former procedure carries a lower risk of multiple pregnancies. How to cite this article Yadav P, Singh S, Singh R, Jain M, Awasthi S, Raj P. To Study the Effect on Fertility Outcome by Gonadotropins vs Laparoscopic Ovarian Drilling in Clomiphene-resistant Cases of Polycystic Ovarian Syndrome. J South Asian Feder Obst Gynae 2017;9(4):336-340.

Clomiphene, Metformin, or Both for Infertility With Polycystic Ovarian Syndrome

2021 ◽  
pp. 240-245
Author(s):  
Tana Kim ◽  
Zaraq Khan
Keyword(s):  
Treatment Option ◽  
Ovulation Induction ◽  
Polycystic Ovarian Syndrome ◽  
Randomized Study ◽  
Induction Treatment ◽  
Multiple Gestation ◽  
Double Blind ◽  
Subsequent Fertility ◽  
Ovarian Syndrome ◽  
Pharmacologic Therapies

The PPCOS trial examines and compares ovulation induction treatments for infertile women with a diagnosis of polycystic ovarian syndrome (PCOS). Both clomiphene and metformin are pharmacologic therapies that have been utilized to promote ovulation and subsequent fertility in women with PCOS. However, it is uncertain if clomiphene, metformin, or a combination of both should be the first-line ovulation induction treatment option for women with PCOS. This study examines fertility and pregnancy outcomes for PCOS women by performing a double-blind, randomized study utilizing 3 different study arms: clomiphene, metformin, and clomiphene plus metformin. This study not only reviews differences in ovulation, pregnancy loss, live birth, and multiple gestation rates between the 3 different study arms, but it also concludes which treatment option is superior for infertile PCOS women seeking treatment.

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