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 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.

scholarly journals Application of Pulsed Rhythmic Drug Administration to Ovulation Induction Therapy in PCOS Patients with Clomiphene-Resistance: a Retrospective Research

2021 ◽  
Author(s):  
Xinyue Zhang ◽  
Aiyan Zheng ◽  
Jihong Yang ◽  
Ting Feng ◽  
Yan Zhang ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Pregnancy Rate ◽  
Therapeutic Effect ◽  
Ovulation Induction ◽  
Polycystic Ovary ◽  
Induction Treatment ◽  
Human Menopausal Gonadotropin ◽  
Ovary Syndrome ◽  
Clomiphene Resistance ◽  
Administration Protocol

AbstractThere is currently a dispute over the choice of ovulation induction treatment for infertile women with polycystic ovary syndrome (PCOS). The objective of this study is to compare the therapeutic effect of pulsed rhythmic administration protocol (PRAP) with conventional letrozole + human menopausal gonadotropin (HMG) in patients with clomiphene-resistance polycystic ovary syndrome (PCOS). A retrospective analysis of 821 intrauterine insemination (IUI) cycles between January 2015 and January 2020 was performed. Of these, 483 cycles were treated with a pulsed rhythmic administration protocol (PRAP), and 338 cycles were treated with conventional letrozole + HMG protocol (LHP). The therapeutic effect of the two protocols has been compared. The pregnancy rate was 18.07% in the LHP and 27.07% in the PRAP. The ongoing pregnancy rate in LHP was 14.46% and in PRAP was 22.73%. The research suggests that PRAP is more effective than LHP and could be an adequate ovulation induction strategy for the IUI cycle of patients with clomiphene-resistance PCOS.

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 Using Of Human Menopausal Gonadotropin Hormone Versus Oral Ovarian Stimulation Agents In Induction Of Ovulation In Women With Polycystic Ovary Syndrome In Salah Al-Deen Hospital/Tikrit City

2020 ◽  
Vol 04 (2) ◽  
pp. 13-25
Author(s):  
Haifaa Ajaj ◽  
Musryia Hassein
Keyword(s):  
Menstrual Cycle ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Controlled Clinical Trial ◽  
Human Menopausal Gonadotropin ◽  
Therapeutic Effects ◽  
Ovary Syndrome ◽  
Significant Difference ◽  
Cycle Group

Polycystic ovary syndrome is a common cause of an ovulatory infertility. Drugs like Aromatase inhibitors, Human menopausal gonadotropin, used for ovulation induction. The aim of this study was carried out to compare the therapeutic effects of gonadotropin hormone versus oral ovarian stimulating agents. A prospective randomized controlled clinical trial was carried out in the Salahdeen general hospital in Tikrit from 1st Feb-30th August 2020. About 75 PCOs patients enrolled randomly in the study and divided equally into 3 groups as below: Group A treated with (75 IU intramuscular HMG gonadotropin) daily for 5 days starting Day 2 of menstrual cycle. Group B treated with oral clomiphene citrate 100 mg daily for 5 days starting Day 2 of menstrual cycle. Group C treated with oral Letrezole 5 mg daily for 5 days starting Day 2 of menstrual cycle. Multiple mature follicles were obtained commonly by HMG, followed by Letrozole, then Clomiphene, this relation was statistically significant. Endometrial thickness was higher among those treated with HMG (10.5±1.7) than those treated by Clomiphene (9.03±0.9), and then treated by letrozole (8.5±1.2). This is a significant difference in ET value between Clomiphene, letrozole, and HMG. Chemical pregnancy (early pregnancy loss that occurs shortly after implantation may account to 50-75% of all miscarriages) was higher among those treated with HMG (20%), while it was (16%) of those treated with Clomiphene, and (12%) of the Letrozole group, this relation was statistically not significant. In conclusion, HMG had the highest response rate, followed by Letrozole, and Clomiphene. The multiple mature follicles was obtained commonly by HMG, followed by Letrozole, then Clomiphene.

Comparison of Clomiphene Citrate Plus N-Acetyl Cysteine and Clomiphene Citrate Alone for Induction of Ovulation in Polycystic Ovary Syndrome

2021 ◽  
Vol 15 (6) ◽  
pp. 1253-1255
Author(s):  
S. Waseem ◽  
S. Gohar ◽  
M. Afzal ◽  
Z. Wali
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovarian Syndrome ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Ovary Syndrome ◽  
Obstetrics And Gynaecology ◽  
Group A ◽  
Acetyl Cysteine ◽  
Group B ◽  
Ovarian Syndrome

Aim: To compare the frequency of ovulation with clomiphene citrate plus N-acetyl cysteine versus clomiphene citrate alone in married females presenting with polycystic ovarian syndrome. Study design: Randomized clinical trial Place and duration of study: Department of Obstetrics and Gynaecology, Unit-3 Jinnah Hospital, Lahore from 1st September 2018 to 28th February 2019. Methodology: A total of 60 patients (30 in each group) were enrolled. In group A, females were prescribed clomiphene citrate 50-mg tablets twice daily with N-acetyl cysteine 1200 mg/day orally for 5 days starting on day 3 of the menstrual cycle and in group B, females were prescribed clomiphene citrate 50-mg tablets twice daily. Results: Patients ranged between 18-35 years of age. Mean age of the patients was 28.5±3.3 and 28.1±3.1 years in group A and B, respectively. Mean duration of marriage in group A was 3.4±0.9 and in group B 3.5±0.9 year. Mean BMI in group-A was 3.4±0.9 while in group-B 3.5±0.9 (kg/m2). Ovulation was observed at 1st month in group A was 12 (40%) and in group B 9 (30%). Ovulation was observed at 2nd month in group A was 16 (53.3%) and in group B 13 (43.3%). In 3rd months ovulation was seen in 19 patients (63.3%) of group A and 18 patients (60%) of group B. Stratification for age and BMI was also carried out. Conclusion: This study could not find any clinical superiority for clomiphene citrate plus N-acetyl cysteine versus clomiphene citrate alone in term of ovulation rate. Keywords: N-acetyl cysteine, Polycystic ovary syndrome, Ovulation induction

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