scholarly journals A study for evaluation of two protocols comprising of clomiphene citrate, human menopausal gonadotropin with or without follicle stimulating hormone for ovulation induction in patients with infertility for intrauterine insemination

2019 ◽  
Vol 8 (6) ◽  
pp. 2487
Author(s):  
Ashok Verma ◽  
Shivani Sharma ◽  
Suresh Verma ◽  
Pankaj Sharma ◽  
Tenzin Tsamo Tenga ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Endometrial Thickness ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Human Menopausal Gonadotropin ◽  
Multiple Gestation ◽  
Group A ◽  
Group B

Background: To compare two protocols comprising of FSH/CC/HMG and CC/HMG for ovulation induction and IUI in women with infertility.Methods: 60 women with unexplained infertility were randomized using sequentially numbered opaque envelope method. Group A received inj FSH 150 units on day 2 of menstrual cycle and clomiphene citrate 100 mg from day 3-7, followed by injection HMG 150 units on day 9 of menstrual cycle. Group B received clomiphene citrate 100 mg from day 3-7, and HMG 150 units on day 7 and 9 of the menstrual cycle.  Ovulation triggered with hCG 5000 units when dominant follicle was 18mm. Single IUI was done 36-42 hours afterwards.Results: Pregnancy occurred in 3 out of 30 women in 116 cycles Group A (with FSH) with a pregnancy rate of 10 percent, and 2.8% per cycle. In group B (without FSH) pregnancy occurred in 3 out of 30 women in 117 cycles with pregnancy rate of 10 percent, and 2.6% per cycle. The number of follicles per cycle was 1.36 and follicle size was 18.57 mm in group A. While in Group B numbers of follicles per cycle were 1.22, with average size of 18.9mm. Mean endometrial thickness was 7.7mm in Group A and 6.37 in Group B (p=.01, significant). Mild OHSS was observed in one woman in Group B. No other side effects were observed in both the groups.Conclusions: The controlled ovarian stimulation regimes used in this study are equally effective, easy to administer, require less intensive monitoring and fewer medications, with little risk of OHSS and multiple gestation.

STUDY FOR EVALUATION OF COMPRISING OF CLOMIPHENE CITRATE, HUMAN MENOPAUSAL GONADOTROPIN WITH OR WITHOUT FOLLICLE STIMULATING HORMONE FOR OVULATION INDUCTION IN PATIENTS WITH INFERTILITY FOR INTRAUTERINE INSEMINATION AT NMCH, JAMUHAR, SASARAM, BIHAR

2021 ◽  
pp. 30-32
Author(s):  
Smriti Sinha ◽  
Rita Sinha ◽  
Debarshi Jana
Keyword(s):  
Menstrual Cycle ◽  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Endometrial Thickness ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Human Menopausal Gonadotropin ◽  
Multiple Gestation ◽  
Group A ◽  
Group B

Background: To compare two protocols comprising of FSH/CC/HMG and CC/HMG for ovulation induction and IUI in women with infertility. Methods: 60 women with unexplained infertility were randomized using sequentially numbered opaque envelope method. Group A received inj FSH 150 units on day 2 of menstrual cycle and clomiphene citrate 100 mg from day 3 - 7, followed by injection HMG 150 units on day 9 of menstrual cycle. Group B received clomiphene citrate 100 mg from day 3-7, and HMG 150 units on day 7 and 9 of the menstrual cycle. Ovulation triggered with hCG 5000 units when dominant follicle was 18mm. Single IUI was done 36-42 hours afterwards. Results: Pregnancy occurred in 3 out of 30 women in 116 cycles Group A (with FSH) with a pregnancy rate of 10 percent, and 2.8% per cycle. In group B (without FSH) pregnancy occurred in 3 out of 30 women in 117 cycles with pregnancy rate of 10 percent, and 2.6% per cycle. The number of follicles per cycle was 1.36 and follicle size was 18.57 mm in group A. While in Group B numbers of follicles per cycle were 1.22, with average size of 18.9mm. Mean endometrial thickness was 7.7mm in Group A and 6.37 in Group B (p=.01, signicant). Mild OHSS was observed in one woman in Group B. No other side effects were observed in both the groups. Conclusions: The controlled ovarian stimulation regimes used in this study are equally effective, easy to administer, require less intensive monitoring and fewer medications, with little risk of OHSS and multiple gestation.

Comparison of letrozole and clomiphene citrate efficacy in terms of ovulation induction and pregnancy rate.

2021 ◽  
Vol 28 (05) ◽  
pp. 749-754
Author(s):  
Nadia Sharif ◽  
Uzma Manzoor ◽  
Saadia Bano ◽  
Uzma Shahzaad
Keyword(s):  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Endometrial Thickness ◽  
Controlled Trial ◽  
Clomiphene Citrate ◽  
Epidemiological Data ◽  
P Value ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: To compare the efficacy of Letrozole and clomiphene citrate in Patients of Anovulation polycystic ovarian syndrome with Infertility. Study Design: Randomized Controlled Trial Setting: Department of Obstetrics and Gynecology Independent Medical College Faisalabad. Period: 30-09-2019 to 29-6-2020. Material & Methods: This study included 100 patients with 50 patients in each group. Group A received 2.5 to 5mg letrozole in each cycle from day 3 to 7. Group B received clomiphene citrate 50 to 100 mg incremental dose depending on ovarian response. Both Drugs were given for consecutive 3 to 6 cycles to see response. Main outcome Measure included optimal follicle size (> 18mm), endometrial thickness, and pregnancy rate. Epidemiological data and efficacy outcome measures were recorded on a Performa. Statistical analysis was done using SPSS version 13. Chi-square test applied and p-value <o.o5 was considered significant. Both group included primary infertility patients. Results: The mean age of patients was 28.03+ 3.02 years. Mean age of group A patients was 29.04+3.44 and 28.47+3.90 group B patients. Mono ovulation in group A patients (88.9%) and 27 in group b patients (60.0%). The mean endometrial thickness was 9.6mm + 1.6 in letrozole group and 6.9mm + 1.2 in clomiphene citrate group A. In group A 18% got pregnant from Letrozole group and 1.1% from the group B. Conclusion: Efficacy was significantly higher in group A Patients received letrozole as compared to patients echo received clomiphene citrate. The effects of Letrozole showed better outcome in terms of Ovulation Induction Endometrial Thickness and Pregnancy rate.

scholarly journals The Study on Different Ovulation Induction Protocols used for Intrauterine Insemination and their Pregnancy Rate in Infertile Couples

2021 ◽  
Vol 10 (11) ◽  
pp. 73-82
Author(s):  
Yaminipriya Devarajlu Dhivya Venkatesan ◽  
Balachandar Vellingiri Ravimanickam Thangarasu ◽  
Sarat Battina
Keyword(s):  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Human Menopausal Gonadotropin ◽  
Fertility Drugs ◽  
Group I ◽  
Significant Difference ◽  
Group B ◽  
Group D

Infertility affects millions of people of reproductive age worldwide and has an impact on their families and communities. Infertility is a disease of male or female reproductive system defined by failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Infertility is treated by different fertility drugs, ovulation induction (OI), intrauterine insemination (IUI) and in-vitro fertilization (IVF). The aim of the study is to find out the significant difference in pregnancy rate with different OI protocols used for IUI. OI is the first line treatment given to infertile women. In OI, medications are given to women for egg development and for release of eggs. OI is monitored by follicular study by ultrasonography. Semen is collected from the male partner and processed with culture media to retrieve high motile sperms, which are injected into the uterus of the female. A prospective randomized study was performed among 1343 IUI cycles. OI is started on Day 2 or Day 3 of the menstrual cycle. OI protocol is grouped according to the fertility drugs used for stimulation. The fertility drugs used for the stimulation are Clomiphene Citrate, Letrozole, Recombinant Gonadotropins, Human menopausal Gonadotropins (HMG), Human chorionic Gonadotropin (HCG). Group A uses Clomiphene citrate and HCG, Group B uses Clome, recombinant Gonadotropins and HCG. Group C uses Clome, Human menopausal Gonadotropin and HCG; Group D uses Letrozole and HCG. Group E uses Letrozole recombinant Gonadotropin and HCG. Group F used Letrozole, Human menopausal Gonadotropin and HCG. Group G used recombinant Gonadotropin and HCG. Group H used Human menopausal Gonadotropin and HCG. Group I uses only HCG. Group J was a natural cycle monitoring without any medication and was used as a control. Pregnancy rates were calculated for different age groups with different protocols. The result shows that Group B had 13% pregnancy, Group C had 9%, Group D had 3%, Group E had 10%, Group G had 11%, Group G had 11%, Group H had 7%, Group I had 4%, and Group J had 8% of pregnancy rate. The statistical analysis shows there is no significant difference with different stimulation protocols used.

scholarly journals Relationship between pregnancy rate and number of intrauterine insemination cycles during the study of comparative efficacy of letrozole and clomiphene citrate adjuvants to gonadotropin stimulation in controlled ovarian stimulation cycles combined with intrauterine insemination therapy

2021 ◽  
Vol 11 (1) ◽  
pp. 106
Author(s):  
Pankaj Sharma ◽  
Ashok Verma ◽  
Kritika Katoch
Keyword(s):  
Pregnancy Rate ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Randomized Study ◽  
Good Alternative ◽  
Human Menopausal Gonadotropin ◽  
Male Factor ◽  
Medical College ◽  
Group A ◽  
Group B

Background: Infertility is commonly defined as the failure of conception after at least twelve months of unprotected intercourse. Factors contributing are both male and female in which unexplained etiology accounts for 51%, male factor 28%, endometriosis 17% and ovulatory disorders 4%.Methods: Prospective, randomized study was conducted at DRRPG medical college, Tanda, Kangra, Himachal Pradesh. In our study, patients were randomized into two groups of 30 each. Women in group A received clomiphene citrate 100mg/day and group B received letrozole 2.5 mg/day from day 3-7 of menstrual cycle. All the patients received human menopausal gonadotropin 75 U given every alternate day from day 5 until HCG administration. Ovulation was triggered with recombinant HCG (5000 IUIM) when the dominant follicles reached 18 mm in diameter. A single IUI was performed 36 hours later. A maximum of four cycles were given.Results: In our study, total number of induction cycles given in group A and B were 120 and 114 respectively. Out of these, 112 and 111 IUI cycles were done in group A and B respectively. A pregnancy rate of 1.66% and 7.87% per IUI cycle was observed in group A and B respectively.Thus it is concluded that the pregnancy rates were significantly higher in letrozole group (30%) in comparison to clomiphene citrate group (6.66%).Conclusions: Aromatase inhibitor letrozole appears to constitute a good alternative to clomiphene citrate in patients with unexplained infertility undergoing gonadotropin-stimulated COS cycles combined with IUI therapy.

scholarly journals LETROZOLE WITH OR WITHOUT GONADOTROPIN AS A FIRST-LINE OVULATION INDUCTION IN ANOVULATORY INFERTILE WOMEN DUE TO POLYCYSTIC OVARY SYNDROME

2018 ◽  
Vol 11 (8) ◽  
pp. 129
Author(s):  
Fadia J Alizzi
Keyword(s):  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Ovulation Rate ◽  
First Line ◽  
Cycle Number ◽  
Group A ◽  
Group B ◽  
Ovarian Syndrome

Objectives: The objective is to evaluate the clinical outcome of using letrozole alone or with gonadotropin as first-line ovulation induction in anovulatory infertile polycystic ovary women. Methods: A prospective single-arm study. 80 infertile polycystic ovarian syndrome (PCOS) women had been recruited between January and October 2017. Letrozole on day 2–3 of the cycle was given. The women are sorted into two groups according to the size of the dominant follicle on day 7 or 8, Group A (letrozole only group) and Group B (letrozole plus gonadotropin).Results: In our study, the overall pregnancy rate was (67.5%) and ovulation rate was 91.3%. The ovulation rate was significantly higher in Subgroup A than B (97.9% vs. 81.3%). Pregnancy rate was higher in Subgroup A (72.9% vs. 59.4%), but it was statistically not significant. The number of follicles was significantly higher in Subgroup B. Endometrial thickness, miscarriages, ovarian hyperstimulation syndrome, and multiple pregnancies were not statistically significant. Lower cycle number independently and significantly predict clinical pregnancy, while body mass index has a modest effect.Conclusions: Letrozole alone or in combination with gonadotropin as a first-line treatment in PCOS may be reasonable since this approach may improve the success rate and minimize the overall costs and risks. 

scholarly journals Comparative Analysis of Effectiveness of Clomiphene Citrate and Letrozole Combined with Low Dose Human Menopausal Gonadotropin for Controlled Ovarian Stimulation in Intrauterine Insemination Cycles

2021 ◽  
Vol 73 (3) ◽  
pp. 198-203
Author(s):  
Padmalaya Thakur ◽  
Sujata Pradhan
Keyword(s):  
Pregnancy Rate ◽  
Ovarian Stimulation ◽  
Low Dose ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Controlled Ovarian Stimulation ◽  
Human Menopausal Gonadotropin ◽  
Group B

Objective: To compare the efficacy of clomiphene citrate and letrozole in combination with low dose human menopausal gonadotropin for controlled ovarian stimulation in intrauterine insemination (IUI) cycles.Methods: During January-2018 to December-2019 for intending 496 IUI cycles, controlled ovarian stimulation was performed with either clomiphene or letrozole combined with human menopausal gonadotropin (hMG), in two arms:  subjects in one arm (Group A) were with clomiphene and hMG in 222 cycles; those in the second arm (Group B) were with letrozole and hMG in 274 cycles. Pregnancy rate and clinical pregnancy rate of both groups were considered as the primary outcomes.Results: Patient characteristics like female age, indications for IUI, type of IUI, endometrial thickness and total motile fraction (TMF) of spermatozoa of male partners were seen similar in both groups. The letrozole-hMG group (Group B) had significantly higher numbers of cycles with single dominant follicle (P=0.01) and human chorionic gonadotropin (hCG) was more frequently used as the ovulation trigger (P=0.03). Pregnancy rate (18.5% vs. 15.3%, P=0.35) and clinical pregnancy rate (18.5% vs. 15.3%, P=0.35) were similar in groups A and B, respectively.Conclusion: Clomiphene citrate and letrozole combined with low dose human menopausal gonadotropin were equally effective for controlled ovarian stimulation in IUI cycles.

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 Clinical Outcomes of Tamoxifen and Clomiphene Citrate in Intrauterine Insemination Cycles

2015 ◽  
Vol 6 (3) ◽  
pp. 118-121
Author(s):  
Asifa Majeed ◽  
PS Divyashree
Keyword(s):  
Menstrual Cycle ◽  
Clinical Outcomes ◽  
Endometrial Thickness ◽  
Intrauterine Insemination ◽  
Transvaginal Ultrasound ◽  
Clomiphene Citrate ◽  
P Value ◽  
Human Menopausal Gonadotropin ◽  
Beta Hcg ◽  
Retrospective Clinical Study

ABSTRACT Background Both selective estrogen receptor modulators, tamoxifen and clomiphene have been used for ovulation induction for patients with anovulatory infertility. The aim of this study is to compare the effectiveness of tamoxifen to clomiphene on clinical outcome in intrauterine insemination (IUI) cycles. Materials and methods It is a retrospective clinical study. Two hundred and seven women undergoing IUI cycles from July 2013 to July 2014 at Milann—The fertility centre, Bengaluru, India were analyzed. Tamoxifen was administered in the dose of 40 mg starting from day 2/3 of the menstrual cycle for a period of 5 days and clomiphene citrate (CC) was administered in the dose of 100 mg from day 2/3 of menstrual cycle for 5 days. Monitoring of ovulation was done by transvaginal ultrasound from day 5/6 till dominant follicle size was more than 18 mm. Highly purified human chorionic gonadotrophin (hCG) in the dose of 5000 IU was given. Double insemination was done at 24 and 36 hours. Luteal phase support was given in form of dydrogesterone 10 mg twice a day for 14 days. Serum beta-hCG was done after 14 days. Result In our study, 76 patients recieved clomiphene citrate (37%) and 126 patients received tamoxifen (62.9%). Both the groups were comparable in terms of age, period of infertility, FSH, LH, antral follicle count and their human menopausal gonadotropin (hMG) requirement (Table 1). Thirteen patients (23.6%) in CC group and 42 patients (76.4%) in tamoxifen group had positive serum beta hCG result. p-value was found to be significant (p = 0.016) (Table 2). Conclusion Tamoxifen was associated with better endometrial thickness and pregnancy rate when compared to clomiphene citrate in ovarian stimulation in IUI cycles. How to cite this article Majeed A, Divyashree PS, Rao KA. Clinical Outcomes of Tamoxifen and Clomiphene Citrate in Intrauterine Insemination Cycles. Int J Infertil Fetal Med 2015;6(3):118-121.

scholarly journals Effects of letrozole alone or letrozole in combination with low-dose intramuscular injection of human menopausal gonadotropin on ovulation and pregnancy of 150 patients with polycystic ovary syndrome

2020 ◽  
Vol 10 (1) ◽  
pp. 164
Author(s):  
Kaiser Ahmad ◽  
Ufaque Muzaffar ◽  
Sadiya Bashir ◽  
Farhat Jabeen
Keyword(s):  
Menstrual Cycle ◽  
Polycystic Ovary Syndrome ◽  
Ovulation Induction ◽  
Intramuscular Injection ◽  
Low Dose ◽  
Polycystic Ovary ◽  
Human Menopausal Gonadotropin ◽  
Ovary Syndrome ◽  
Group A ◽  
Group B

Background: Objective of the study was to explore the effects of letrozole (LE) in combination with low-dose intramuscular injection of human menopausal gonadotropin (HMG) on the ovulation induction and pregnancy of patients with polycystic ovary syndrome (PCOS).Methods: The study comprised of 150 couples who were randomly divided into two groups of 75 each. Group “A” received letrozole (LE) in a dose of 2.5 mg to 5mg /d. LE was started orally starting on 3rd to 5th day of menstrual cycle for 5 consecutive days. Group “B” received letrozole in a dose of 2.5 to 5 mg/day starting on the 3rd to 5th day of menstrual cycle for 5 consecutive days. Starting from the day of oral administration of letrozole, 75 IU HMG was injected intramuscularly on alternate days for 5 consecutive doses. The ovulation induction parameters and pregnancy outcomes were observed.Results: The Group A (LE group) had the most completed cycle (310 cycles), 157 (52.3%) of which had ovulation. The Group B (LE+HMG) group completed the fewest cycles (258 cycles), with 168 (65.1%) of them ovulating. This difference was statistically significant (P<0.05). On HCG injection day, both the endometrial thickness (11.5±1.2) and number of mature follicles (2.1±1.3) of the Group B were significantly higher than those of Group A (P<0.001), but the follicle diameters were similar (P>0.05) The pregnancy rate of the Group B was 54.7%, which was significantly higher than that of the Group A (29.3 %) (P<0.05) The average medication cycle of the Group B group was significantly shorter than that of the Group A (P<0.05).Conclusions: The regimen using LE in combination with low-dose intramuscular injection of HMG has satisfactory therapeutic effects on ovulation induction, short medication cycle and high clinical pregnancy rate, which is promising for treating patients with PCOS infertility.

scholarly journals Letrozole Versus Clomiphene Citrate for Superovulation in Intrauterine Insemination Cycles - Retrospective Comparative Study Conducted in the Department of Reproductive Medicine, Mahatma Gandhi Medical College & Hospital, Jaipur

2021 ◽  
Vol 10 (27) ◽  
pp. 1991-1995
Author(s):  
Jawahira Chishti ◽  
Jai Chowdhary ◽  
Archana Paliwal ◽  
Chetan Kumar Sharma ◽  
Manisha Choudhary
Keyword(s):  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Endometrial Thickness ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Peripheral Tissues ◽  
Sperm Density ◽  
Estrogen Production ◽  
Oral Agents ◽  
Significant Difference

BACKGROUND Superovulation with intrauterine insemination (IUI) increases the probability of pregnancy by increasing number of oocytes and sperm density. The main oral agents used for superovulation are clomiphene citrate and letrozole. Clomiphene citrate a selective estrogen receptor modulator with predominant antiestrogenic action has adverse effects on endometrium and cervical mucous. Letrozole an aromatase inhibitor acts by reducing estrogen production by blocking androgen conversion to estrogen in ovary and peripheral tissues without affecting endometrium and cervical mucous. We wanted to compare the efficacy of letrozole v/s clomiphene citrate as first line ovulation induction drug in infertile patients undergoing IUI. METHODS Based on the inclusion and exclusion criteria, we included 160 patients in our study. They were divided into two groups of 80 each based on the drug given for ovulation induction. The drug was given for 5 days from D3 to D7 of menstrual cycle. IUI was done 38 - 40 hours after trigger and after confirmation of ovulation by sonography. RESULTS The mean age, body mass index (BMI), duration of infertility, type and cause of infertility in both groups were similar. Ovulation rate was 85 % in letrozole group and 71.25 % in clomiphene citrate group, which was statistically significant (P0.035). There was no statistically significant difference between endometrial thickness and total days till ovulation between two groups. Monofolliculogenesis and clinical pregnancy rate were statistically significantly higher in letrozole group. CONCLUSIONS Our study shows that letrozole has better pregnancy rate in comparison to clomiphene citrate (C. C.) in IUI cycles with less risk of anovulation, thin endometrium and multi follicular growth. KEY WORDS Clomiphene Citrate (C.C.), Letrozole (LTZ), Ovulation Induction (OI), Intrauterine Insemination (IUI)

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