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

2017 ◽  
Vol 6 (9) ◽  
pp. 4098 ◽  
Author(s):  
Amitoj Athwal ◽  
Ratnabali Chakravorty ◽  
Dipanshu Sur ◽  
Rupam Saha
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Prospective Trial ◽  
Serum Estradiol ◽  
Ovary Syndrome ◽  
Infertile Women ◽  
Ovulation Stimulation ◽  
Group Serum

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.

scholarly journals Clomiphene Citrate versus Letrozole for Induction of Ovulation in Infertile women having Polycystic Ovarian Syndrome (Randomized Controlled Trial)

2021 ◽  
Vol 4 (7) ◽  
pp. 01-09
Author(s):  
Abdel Rahman Mohammed Saleh ◽  
Mahmoud Youssef Ali Ahmed Abdalla ◽  
Nourhan Adel Abu Elfotouh Tantawy
Keyword(s):  
Menstrual Cycle ◽  
Polycystic Ovary Syndrome ◽  
Congenital Adrenal Hyperplasia ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
P Value ◽  
Adrenal Hyperplasia ◽  
Ovary Syndrome ◽  
Infertile Women

Background: Polycystic ovary syndrome is a disorder but with unclear etiology that its diagnosis depends on exclusion of other etiologies with ovulatory disorders and androgen excess as congenital adrenal hyperplasia, 21-hydroxylase deficient non classic congenital adrenal hyperplasia (NCAH), adrenal or ovarian androgen-secreting tumors, disorders of adrenocortical dysfunction as Cushing’s disease, and abuse of androgenic or anabolic drugs. Polycystic ovary syndrome affects approximately 6-15% of women in reproductive age and constitutes 50% of the causes of infertility in women. Aim of the Work: To compare the efficacy of letrozole on ovulation induction to that of clomiphene citrate in women suffering polycystic ovary syndrome and the effect on the follicular maturation, endometrial thickness and pregnancy rate. This study was carried in the outpatient infertility clinic of Ain-Shams Maternity Hospital during the period from November 2020 till April 2021. Patients and Methods: This study included 80 infertile women diagnosed as having polycystic ovary syndrome. Women were randomized into two groups. Letrozole group (1) included 40 women who were given the aromatase inhibitor (Letrozole) orally in a 5mg dose daily from day 3 to day 7 of the menstrual cycle. While Clomiphene citrate group (2) included 40 women who were given the clomiphene citrate orally in 100mg dose daily from day 3 to day 7 of the menstrual cycle. All women were counseled and informed consent was obtained before recruitment. Results: In this study, ovulation rate was significantly more frequent in the Letrozole group (82.5%, 33 women reached ovulation successfully) than in Clomiphene citrate group (60%, 24 women reached ovulation successfully) within P value=0.024. Clomiphene citrate at a dose of 100mg showed more efficacies in the number of follicle ≥18mm than Letrozole at a dose of 5mg. In Letrozole group, the number of follicles (≥18mm in diameter) ranged from 1 to 2 with a Mean±SD= 1.4±0.65 and in Clomiphene citrate group, the number of follicles (≥18mm in diameter) ranged from 1 to 3 with a Mean±SD= 1.9± 0.41 (P value=0.0001). Conclusion: Letrozole can be considered as a first line treatment of anovulation in polycystic ovary syndrome. But, moreover studies including larger number of cases will further confirm the efficacy of letrozole versus clomiphene citrate in induction of ovulation, reaching to the optimum doses for aromatases inhibitors, more observation on endometrial thickness, incidence of pregnancy outcomes, incidence of abortion and incidence of congenital fetal malformations.

scholarly journals COMPARISON OF EFFECT OF CLOMIPHENE CITRATE WITH ESTRADIOL VALERATE V/S LETROZOLE ON PREGNANCY RATE IN INFERTILE WOMEN WITH PCOS

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Mendiratta Suman ◽  
Joshi Amit Kumar ◽  
Netra Harendra Kumar
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Pregnancy Rate ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Estradiol Valerate ◽  
Ovary Syndrome ◽  
Infertile Women ◽  
Group A ◽  
Group B

Background: Polycystic ovary syndrome is the commonest endocrinopathy in anovulatory infertility in young women. It is estimated that infertility affects 10 to 14% of the Indian population of which approximately 25-30% part occupied by PCOS. Methods: This prospective study enrolled 180 infertile women with PCOS, age 21-35 yrs who have taken 1 cycle of clomiphene citrate 100 mg, endometrial thickness <7 mm inspite of follicles greater than 18 mm. Half of them treated with clomiphene citrate with estradiol valerate and remaining half with letrozole. Results: In Group-A treated with clomiphene citrate with estradiol valerate 13 patients (16.3%) conceived and in Group-B treated with letrozole 26 patients (32.5%) conceived. Conclusion: Pregnancy rate is higher in group which treatment with letrozole in comparison with clomiphene citrate plus estradiol valerate. Keywords: Polycystic ovary syndrome, Infertility, Pregnancy rate

scholarly journals Impact of Luteal phase clomiphene citrate on endometrial thickness and clinical pregnancy rates in women with polycystic ovary syndrome

2020 ◽  
Vol 11 (3) ◽  
pp. 158-161
Author(s):  
Elsayed Elshamy ◽  
Ayman Soliman
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Luteal Phase ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Clinical Pregnancy ◽  
Ovary Syndrome ◽  
Clinical Pregnancy Rates ◽  
Group 2 ◽  
Group 1

Objective: To compare between luteal phase clomiphene citrate and second cycle day clomiphene citrate on the thickness of the endometrium and clinical pregnancy rates in women with polycystic ovary syndrome. Methods: a prospective observational study conducted on 196 women with Polycystic ovary syndrome divided into two groups: Group 1 (98 patients) received 100mg of clomiphene citrate daily for 5 days starting on second cycle day and Group 2 (98 patients) received 100mg of clomiphene citrate daily starting in the luteal phase before onset of withdrawal bleeding for 5 days. Treatment and follow up applied for three cycles. Outcome measures were collected and analyzed and women who got pregnant were followed until 12 weeks of pregnancy. Results: no significant differences between the two groups regarding pre-ovulatory endometrial thickness (8.3mm in group 1vs 8.8mm in group 2), number of mature follicles (1.62 in group 1vs 1.57 in group 2) and mid-luteal serum progesterone levels(14.63ng/ml in group 1vs 14.9ng/ml in group 2). 34 women (35%) got pregnant in group 1 and 37 women (38%) in-group 2 and three patients had miscarriage in each group without any statistical significance. Conclusion: the present study does not support luteal clomiphene citrate over second cycle day clomiphene citrate to induce ovulation in infertile women with polycystic ovary syndrome.

scholarly journals PRESCRIPTION PATTERN IN OBESE AND NON-OBESE INFERTILE WOMEN WITH POLYCYSTIC OVARY SYNDROME IN A TERTIARY CARE HOSPITAL

2018 ◽  
Vol 11 (3) ◽  
pp. 53
Author(s):  
Asha Avirah Mm ◽  
Aswathy Alias ◽  
Manjusha Sajith ◽  
Vandana Nimbargi ◽  
Shivhar Kumdale
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Treatment Options ◽  
Tertiary Care ◽  
Care Hospital ◽  
Lifestyle Modifications ◽  
Ovary Syndrome ◽  
Infertile Women ◽  
Current Medication

 Objective: The objective of this study is to evaluate the treatment options for the management of obese and non-obese infertile women with polycystic ovary syndrome (PCOS).Methods: A prospective observational study was conducted with 75 infertile PCOS women. The demographic details, body mass index, menstrual patterns, and current medication related to infertility were noted. The collected data were statistically represented in terms of range, frequency tables, and standard deviation wherever appropriate.Results: A majority of the infertile PCOS women were aged 24–27 years with a mean age of 25.72±3.53 years, belonging to middle socioeconomic class (44%) and mostly found to be urban residents 68%. Most of the PCOS women were overweight (32%) and obese (21%) with irregular menstrual pattern (90.67%). In combination therapy, clomiphene citrate (CC) pre-treated with oral contraceptives (OC) (37.93%) was mostly given to obese PCOS patients followed by CC with metformin pre-administered with OC (31.03%), whilen on-obese PCOS patients were mostly administered CC with gonadotropins pre-treated with OC(44%). In single therapy, OC was mostly administered to both non-obese (90%) and obese PCOS patients (88.90%).Conclusion: This study concluded that most of the infertile PCOS women were overweight and obese, a major risk actor causing hyperandrogenicity. CC pre-treated with OC and metformin with CC pre-treated with OC were mostly prescribed to obese PCOS patients. Lifestyle modifications along with treatment are strongly recommended, especially in obese PCOS patients.

scholarly journals Endometrial and follicular development following stair-step and traditional protocols in women with polycystic ovary syndrome: An RCT

2021 ◽  
Author(s):  
Sholeh Shahgheibi ◽  
Fariba Seyedoshohadaei ◽  
Danial Khezri ◽  
Solmaz Ghasemi
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Ovarian Follicles ◽  
Left Ovary ◽  
Ovulation Rate ◽  
Control Group ◽  
Ovary Syndrome ◽  
Significant Difference

Background: Various strategies have been proposed for polycystic ovary syndrome (PCOS) treatment. Objective: To investigate and compare the number and size of ovarian follicles, endometrial thickness, and ovulation rate by traditional protocol (TP) and stair-step protocol (SSP). Materials and Methods: Sixty infertile PCOS women were allocated into two groups (SSP = 30 and control TP = 30) between May and October 2019 in the Besat Hospital, Sanandaj, Iran. In the SSP group, the infertile women were treated with 50 mg/daily clomiphene citrate (CC) for five days, while the nonresponsive women were prescribed 100 mg daily CC for five days in the same cycle. The maximum dose (150 mg) was administered until ovulation occurred. In the control group, in non-ovulatory cases, the dose was increased in the next cycle. Ultrasound was used to detect ovulation. Results: Endometrial thickness changes with various doses of CC were significantly different in the TP. The comparison of both protocols showed a significant difference in endometrial thickness only at 50 mg CC. The number of follicles in the left ovary was significantly different in both protocols at 150-mg CC. The size of ovarian follicles in the left ovary was significantly different between the two protocols at 100-mg CC. The ovulation rate was significantly different in the SSP at 100- and 150-mg doses of CC. Moreover, 86% of ovulation occurred at 100-mg CC in the SSP, while this rate was 73% in the TP. Conclusion: The most appropriate dose for ovulation in patients with PCOS is 100 mg CC. Key words: Polycystic ovary syndrome, Clomiphene, Infertility, Ovulation induction.

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