scholarly journals Comparison of ovulation induction with letrozole plus dexamethasone and letrozole alone in infertile women with polycystic ovarian disease: An RCT

2020 ◽  
Author(s):  
Farahnaz Farzaneh ◽  
Fatemeh Afshar
Keyword(s):  
Pregnancy Rate ◽  
Endometrial Thickness ◽  
Ovarian Response ◽  
Male Factor ◽  
Polycystic Ovarian Disease ◽  
Ovarian Disease ◽  
Infertile Women ◽  
Follicle Diameter ◽  
Group I ◽  
The Mean

Background: Infertility is characterized by the inability to obtain a successful pregnancy after 6 months or more with unprotected and regular intercourse. In developing countries, the incidence of infertility is 2%. The causes of infertility could be male factor or female factor, or mixed factor. Objective: This study was conducted with the aim of comparison the ovarian response to letrozole alone and letrozole plus dexamethasone in infertile women with poly cystic ovarian disease (PCOS). Materials and Methods: This randomized clinical trial was conducted on 120 infertile women with PCOS referred to Ali-Ebne-Abitaleb hospital, Zahedan, Iran from February to August 2017 into two groups: group I received letrozole alone and group II recived letrozole plus dexamethasone. The endometrial thickness, follicle diameter, and ovulation were evaluated and compared by ultrasound on days 12 to 14. Results: The mean thickness of endometrium was not different between two groups. Pregnancy rate was 8% in letrozole group and 23% in Letrozole plus Dexamethasone (p = 0.024). Also, the mean diameter of follicles in two groups were not statistically significant. Conclusion: Overall, this study showed that dexamethasone may increase pregnancy rate. Key words: Letrozole, Dexamethasone, PCOS, Induction ovulation.

scholarly journals Clomiphene citrate plus N-acetyl cysteine versus letrozole for induction of ovulation in infertile patients with polycystic ovarian disease: a randomized clinical trial

2019 ◽  
Vol 8 (10) ◽  
pp. 3959
Author(s):  
Momen A. Kamel ◽  
Ahmed F. Amin ◽  
Tarek A. Farghaly ◽  
Nawal A. Farrag
Keyword(s):  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Clinical Pregnancy ◽  
Ovulation Rate ◽  
Ovarian Hyperstimulation ◽  
Polycystic Ovarian Disease ◽  
Ovarian Disease ◽  
Infertile Patients

Background: Polycystic ovarian disease (PCOD), a common endocrine disorder with multisystem affection, is the most common cause of anovulatory infertility. Our objective is to evaluate the effect of using clomiphene citrate (CC) plus N-acetyl cysteine (NAC) versus letrozole in ovulation induction in infertile patients with PCOD.Methods: Reproductive-aged infertile women either primary or secondary diagnosed as PCOD according to Rotterdam criteria, 2003 were considered for enrollment. Eligible women for were recruited and randomized (1:1) to receive either CC 100 mg plus NAC 600 mg (CC+NAC arm) or letrozole 5 mg (NCT03241472, clinicaltrials.gov). All medications were started from day 3 of the menstrual cycle for 5 days. The primary outcome was the ovulation rate in both groups. Secondary outcomes included the mid-cyclic endometrial thickness, ovarian hyperstimulation, and clinical pregnancy and miscarriage rates.Results: One hundred ten patients were enrolled and randomized to CC+NAC arm (n=55) or letrozole (n=55). The ovulation rate in patients in letrozole arm was significantly higher than CC+NAC arm (71.8% versus 53.2%, p=0.01). Additionally, endometrial thickness was higher in letrozole arm (mean±SD: 11.46±1.61 versus 9.0±1.13, p=0.031). However, no statistical significant difference with regarding the ovarian hyperstimulation rate (1.8% versus 3.6%, p=0.157), clinical pregnancy rate [3/19 patients (27.3%) versus 19/55 (34.5%), p=0.409] and miscarriage rate [4/15 patients (26.7%) versus 19/55 (15.8%), p=0.317] in CC+NAC versus letrozole groups respectively.Conclusions: Addition of NAC to CC in ovulation induction leads to comparable pregnancy rate as letrozole. However, letrozole produces high ovulation rate and the better mid-cyclic endometrial thickness.

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 Explained infertility among the couple attending the infertility unit of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh

2015 ◽  
Vol 23 (1) ◽  
pp. 114-120
Author(s):  
Arifa Sultana ◽  
Shaorin Tanira ◽  
Sanchita Adhikary ◽  
Kashfia Ahmed Keya ◽  
Sayeba Akhter
Keyword(s):  
Semen Analysis ◽  
Ovarian Dysfunction ◽  
Male Factor ◽  
Cross Sectional ◽  
Polycystic Ovarian Disease ◽  
Ovarian Disease ◽  
Tubal Occlusion ◽  
Fibroid Uterus ◽  
Common Causes ◽  
Medical University

Context: The causes of infertility vary from country to country among different cultural, environmental and socio economic groups. The aim of the study was to explain the causes of infertility among the couple attending infertility unit of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh and to compare with previous studies of both local and abroad. Methods: This cross sectional study was carried out between September 2007 and March 2008 at infertility unit of BSMMU Hospital, Dhaka, among 110 couples, who had tried unsuccessfully for more than one year to reproduce. The data included history, physical examination and relevant investigations for female partners and male partners. Results: The age group of 25-30 years was the most vulnerable as they represented 52% of primary and 51.42% of secondary infertility. Among the 110 subfertile couples, 43.63% had female factor problems; 20% were suffering from male factor problems. In 21.81% of cases both male and female were responsible. In 14.54% cases, there were no causes, and, therefore, remain unexplained infertility. Among women, primary subfertility was 68.18%, secondary subfertility was 31.81% and among men, it was 79% and 21% respectively. Most of the infertile couples (43.64%) were trying for 2-5 years. In this study, most common cause was ovarian dysfunction (33.63%). Among them, anovulation with regular menstruation was found in 60%, polycystic ovarian disease in 32%, hyperprolactinaemia in 16% cases. Bilateral tubal occlusion was found in 8% and pelvic adhesions in 24% by doing laparoscopy. In addition, 10% of patients had endometriosis. Fibroid uterus was found in 26% cases. Among the primary subfertility cases, common causes were anovulation with regular menstruation (14.66%) and polycystic ovarian disease (12%). 40% of secondary subfertility was related with menstrual regulation (MR). Among male factors, azoospermia was found in 6.36% cases, oligozoospermia in 10.9% cases, asthenozoospermia 18.18%, teratozoospermia was in 6.36% cases. Conclusion: Primary subfertility cases were more common than secondary subfertility cases. Ovarian dysfunction was the common causes of subfertility. Other factors were abnormal semen analysis, endometriosis, tubal occlusion, pelvic adhesions and fibroid uterus. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22705 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 114-120

A controlled clinical trial for the effect of bromocriptine on the adrenal contribution in polycystic ovarian disease

1987 ◽  
Vol 114 (2) ◽  
pp. 161-165 ◽  
Author(s):  
Gamal H. El Tabbakh ◽  
Ibrahim A. Loutfi ◽  
Ibrahim Azab ◽  
Hany A. Rahman ◽  
Fatma A. Aleem ◽  
...  
Keyword(s):  
Control Group ◽  
Controlled Clinical Trial ◽  
Dehydroepiandrosterone Sulphate ◽  
Disease Group ◽  
Normal Range ◽  
Significant Drop ◽  
Polycystic Ovarian Disease ◽  
Ovarian Disease ◽  
Therapeutic Value ◽  
The Mean

Abstract. Adrenal involvement in polycystic ovarian disease was assessed by measuring dehydroepiandrosterone sulphate in 20 polycystic ovarian disease patients. The response of dehydroepiandrosterone sulphate to bromocriptine treatment was compared to that of placebo, both being given for one cycle on a doubleblind, cross over basis. The mean basal DHEA-S was above the upper limit of the normal range (6793 nmol/l) in three patients. The mean basal dehydroepiandrosterone sulphate in the polycystic ovarian disease group was significantly higher than the mean of the normal control group (P < 0.01). Dehydroepiandrosterone sulphate showed a significant drop with bromocriptine as compared to placebo (P < 0.001) and a significant correlation with prolactin both before (P < 0.001) and after treatment with bromocriptine (P < 0.001). These findings support the hypothesis of adrenal involvement in polycystic ovarian disease and prove the significant effect of bromocriptine on the adrenal which might be of therapeutic value.

scholarly journals Outcome of GnRH antagonist ICSI cycles triggered by GnRH agonist plus Recombinant hCG versus triggered with Recombinant hCG alone in fresh autologous ICSI cycle

2020 ◽  
Vol 10 (1) ◽  
pp. 119-131
Author(s):  
Wafaa Mohammed Abed ◽  
Mohammed Oda Selman
Keyword(s):  
Pregnancy Rate ◽  
Oocyte Maturation ◽  
Standard Dose ◽  
Statistical Significance ◽  
Control Group ◽  
Infertile Women ◽  
Final Oocyte Maturation ◽  
Reproductive Techniques ◽  
The Mean ◽  
The Difference

To explore whether dual triggering for final oocyte maturation using a low dose of recombinant human chorionic gonadotropin (hCG) plus gonadotropin-releasing hormone agonist (GnRH-a) is as effective as the standard dose of recombinant hCG triggering alone in term of a total number of retrieved oocytes, fertilization and pregnancy rate in fresh autologous antagonist intracytoplasmic sperm injection (ICSI) cycles. 80 infertile women undergoing ICSI, aged ˂ 40 years, 18˂ Body mass index ˂30 Kg/m2 included in fresh autologous antagonist ICSI cycles. 40 women received a Standard dose of recombinant hCG (500 µg) alone and 40 women received GnRH-a (0.2 mg triptorelin plus 250 µg recombinant hCG) were used for final oocytes maturation. This study was conducted at the High Institute for Infertility Diagnosis and Assisted Reproductive Techniques, Al Nahrain University. The mean total number of retrieved oocytes, fertilization, and pregnancy rate were measured. The mean total oocyte number being statistically higher in the dual trigger group. The mean number of fertilized oocytes and clinical pregnancy rates was higher in the dual trigger group than in the control group, but the difference showed borderline statistical significance. Furthermore, fertilization rates show no statistical difference between the control group and the dual trigger group. Results of the study confirm that dual triggers show favorable improvement in fresh autologous antagonist ICSI cycles with the use of GnRH agonists plus hCG compared with hCG alone for triggering of final oocyte maturation.

TRANSVAGINAL SONOGRAPHIC ASSESSMENT OF FOLLICULAR DEVELOPMENT AND ENDOMETRIAL THICKNESS IN LETROZOLE STIMULATED CYCLES OF PCOS AND NON-PCOS INFERTILE WOMEN

2021 ◽  
pp. 7-9
Author(s):  
Anshu Anshu ◽  
Usha Kumari ◽  
Debarshi Jana
Keyword(s):  
Menstrual Cycle ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Follicular Development ◽  
Study Groups ◽  
Transvaginal Sonography ◽  
Infertile Women ◽  
Follicle Diameter ◽  
Anovulatory Infertility

Background: Infertility in polycystic ovary syndrome (PCOS) is one of the leading causes of anovulatory infertility. Ovulation induction is indicated for the management of anovulatory infertility in PCOS and for augmentation of ovulation in ovulatory infertility, in unexplained infertility. The aim of this retrospective study was to compare and determine the efcacy of letrozole administration in infertile women with PCOS to that of infertile women without PCOS by transvaginal sonography. This Methods: study was done at Obstetrics and Gynaecology Department of JLNMCH, Bhagalpur, Bihar from January to December 2020. Fifty six infertile women including 16 diagnosed as having PCOS and 40 infertile women with regular menstrual cycle (non-PCOS) were included in this study. Patients were treated with letrozole 7.5 mg/day from day 2-6 of the menstrual cycle. Subjects were monitored once during the days 11 to 14 of the cycle by transvaginal ultrasound. Main outcome measures were number of ovulatory follicles, dominant follicle diameter and endometrial thickness. Letrozole as an ovulation inducing drug was found equally effective in t Results: erms of follicular recruitment, follicular maturation and endometrial development both in PCOS and non-PCOS women, as there was no signicant difference regarding mature follicular development and endometrial response between the two study groups. Association of endometrial response particularly with follicular diameter 18 mm or more among the study groups revealed no statistically signicant difference. In conclusion, our results indicate that the Conclusion: effect of letrozole on endometrial thickness and follicular development in patients of anovulatory PCOS did not signicantly differ compared to non-PCOS infertile women.

scholarly journals Role of endometrial thickness in natural and stimulated cycles in infertility

2020 ◽  
Vol 9 (7) ◽  
pp. 2872
Author(s):  
Vandana Dhama ◽  
Kiran Kumari ◽  
Rachna Chaudhary ◽  
Shakun Singh
Keyword(s):  
Pregnancy Rate ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Uttar Pradesh ◽  
Sildenafil Citrate ◽  
Estradiol Valerate ◽  
Thin Endometrium ◽  
Infertile Women ◽  
Medical College

Background: The endometrium plays an important role in infertility. The growth of endometrium depends on serum oestradiol level and blood flow to the uterus. A thin endometrium is defined as a lining of less than 7 mm which is associated with infertility. The endometrium is best seen on Transvaginal scan (TVS). The purpose of this study was to evaluate the role of endometrial thickness and its outcome in natural and stimulated cycles in infertile women.Methods: This prospective cohort study was conducted from June 2018 to May 2019 in LLRM Medical College Meerut, Uttar Pradesh, India. Total 150 infertile women of age less than 35 years presented with either primary or secondary infertility were enrolled. Each patient was undergoing transvaginal scan (TVS) to measure endometrial thickness follicular monitoring.Results: The endometrial thickness and pregnancy rate was higher in letrozole induced group as compared to clomiphene with estradiol valerate and clomiphene with sildenafil citrate induced group.Conclusions: Letrozole had better effect on endometrial thickness and pregnancy rate as compared to clomiphene citrate with estradiol valerate and clomiphene citrate with sildenafil citrate.

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