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

Author(s):  
Sinan S. Ay ◽  
Özer Birge ◽  
Mehmet S. Bakır ◽  
Ayşe E. Yumru

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.

2016 ◽  
Vol 8 (9) ◽  
pp. 281
Author(s):  
Masomeh Rezai ◽  
Mohmmad Jamshidi ◽  
Robabeh Mohammadbeigi ◽  
Fariba Seyedoshohadaei ◽  
Somaye Mohammadipour ◽  
...  

The aim of this study was to compare the effects of Metformin and Acarbose accompanying Clomiphene on the successful ovulation induction in infertile women with polycystic ovary syndrome.This randomized double blind clinical trial study was performed on 60 women with polycystic ovary syndrome. Women were selected and randomly divided in two control and intervention groups. Intervention group received Acarbose 100 mg/day for 3 months. In the first, second, and third weeks, they received 1 tablet, 2 tablets, and 3 tablets per day respectively. In addition, they received 100 mg Clomiphene from third to seventh day of menstruation, during the 3 month treatment period. The control group received Metformin 500 mg/day for 3 months. In the first, second, and third weeks, they received 1 tablet, 2 tablets, and 3 tablets per day respectively. In addition, they received 100 mg Clomiphene from third to seventh day of menstruation, during the 3 month treatment period. All the subjects in both groups before and after the treatment were examined for hirsutism, acne, oral glucose tolerance test, serum triglycerides, cholesterol, LDL, HDL. Also, induction of ovulation was assessed by vaginal ultrasound. The Mean of BMI and fasting glucose tolerance test in Acarbose group was less than Metformin group (P = 0.05). The mean of triglycerides, LDL and HDL levels did not differ between the two groups after the intervention (P > 0.05). The mean of cholesterol levels were different in the two groups after the intervention (P = 0.04). Frequency of ovulation induction in those who received Acarbose (78.5%) was more than those who received Metformin (46.6) (P = 0.012). Comparing with Metformin, Acarbose accompanying Clomiphene was more effective in ovulation induction and decreasing body mass index in infertile women with polycystic ovary syndrome.


2016 ◽  
Vol 69 (1-2) ◽  
pp. 25-30 ◽  
Author(s):  
Artur Bjelica ◽  
Jelena Bjelanovic ◽  
Natasa Milic ◽  
Ljiljana Mladenovic-Segedi ◽  
Djordje Ilic ◽  
...  

Introduction. Polycystic ovary syndrome is the most frequent endocrine disturbance in the reproductive period of women?s life and the most frequent cause of anovulatory infertility. Ovulation and pregnancy in patients having polycystic ovary syndrome may be a result of a wide range of therapeutic options, and the treatment assumes a gradual approach - from simple noninvasive to expensive and demanding procedures. Material and Methods. A systematic literature survey concerning the efficiency of particular ovulation induction methods in respect of the reproductive outcome was carried out with the aim of establishing the algorithm for ovulation induction in infertile patients having polycystic ovary syndrome. The search was confined to clinical investigations performed on human subjects, reported in English in the period from the beginning of 2010 to June of 2014. Conclusion. As a conclusion of this system?atic survey of the efficiency of ovulation induction methods, which confirms and supplements the knowledge in this field, it is possible to form the algorithm for ovulation induction in infertile patients having polycystic ovary syndrome, consisting of the following subsequent steps: 1) modification of life style, 2) induction with clomiphene citrate 3) use of metformin, 4) use of aromatase inhibitors, 5) application of gonadotropins and laparoscopic ovarian drilling - as a second-line treatment, and 6) assisted reproductive techniques.


2019 ◽  
Vol 3 (2) ◽  
pp. 01-05
Author(s):  
Hesham Ammar

This prospective observational study was conducted on 220 patients with polycystic ovary syndrome (PCOS) and subclinical hypothyroidism (SCH) who were allocated into two groups; group one (n=112) received clomiphene citrate (CC) plus thyroxine while group two received only CC for ovulation induction. Patients receiving CC and thyroxine exhibited higher ovulation rate (p<0.001), higher endometrial thickness (p<0.05), higher number of dominant follicles (p<0.001) and higher pregnancy rate (p<0.001) compared to their counterparts receiving only CC. Thyroxine supplementation improves ovulation and pregnancy rates in infertile patients with PCOS and SCH receiving CC for ovulation induction who are therapy naïve.


Author(s):  
Preeti Suhas Deshpande

Background: Normo-gonadotrophic anovulation is the most prevalent anovulatory infertility type. Polycystic ovary disease (PCOS) is by far the most common cause in this category, accounting for 85 % of females who are anovulatory. Its prevalence is growing increasingly with increasing modernisation. Ovulation induction in PCOS females is a problem and the best drug for ovulation induction is still debatable. Aims & objectives: In the current research, we evaluated the efficacy of clomiphene citrate in infertile women with polycystic ovary disease for ovulation induction and pregnancy rates. Material and Methods: The present research was a prospective study conducted with PCOS, willing to participate and follow up in women with primary/secondary infertility. Rotterdam criteria were used to diagnose PCOS. Using descriptive statistics, statistical analysis was performed. Results: Initially, 140 patients in the current study were recruited. For the current research, 128 patients either born or cared for a full 6 months were considered. 21-25 years of age was the most common age group. The mean age of the patients examined was 26.34 ± 3.6 years. 55 % were having average BMI patients, while 34% were overweight. Primary infertility was present in 77 percent of patients. 73 per cent of patients had infertility duration of 1-5 years. 30 percent have a history of laparoscopic ovarian drilling in patients. In 58 percent, hirsutism was noted. Following serial USG monitoring, mono-follicular development (55 %) was more prevalent than multi-follicular development at the end of the study (45 percent). The mean thickness of the endometrium was 7.78 ± 2.58 mm. The mean days for clomiphene citrate ovulation are 14.84 ± 3.46. Average P4 values on day 21 were 11.48 ± 6.44 ng/ml. At the end of the study, 66 % ovulation rate, 28 % pregnancy rate, and 2 % multiple pregnancy incidence were noted. Conclusion: Ovulation induction with clomiphene citrate should be considered as the first line of treatment for infertile women with PCOS. Initial assessment and careful selection of patients increases pregnancy rates. Keywords: ovulation induction, polycystic ovary disease, clomiphene citrate, pregnancy rate.


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