scholarly journals PREGNANCY RATE FOLLOWING LUTEAL PHASE SUPPORT IN POLYCYSTIC OVARY WOMEN USING LETROZOLE WITH OR WITHOUT GONADOTROPIN AS OVULATION INDUCTION

2018 ◽  
Vol 11 (9) ◽  
pp. 321
Author(s):  
Fadia J Alizzi
Keyword(s):  
Pregnancy Rate ◽  
Luteal Phase ◽  
Ovulation Induction ◽  
Polycystic Ovary ◽  
Primary Outcome Measure ◽  
Luteal Phase Support ◽  
Randomized Clinical Study ◽  
Group A ◽  
The Difference ◽  
Group B

Objective: The objective of the study was to evaluate the effect of luteal phase progesterone supplementation on pregnancy rates in anovulatory infertile polycystic ovary women using letrozole with or without gonadotropin as ovulation induction (OI).Method: A prospective randomized clinical study conducted in the infertility clinic - Al-Yarmouk Teaching Hospital, Baghdad/Iraq from June 2016 to January 2018. A total of 149 infertile polycystic ovary women who achieved ovulation using letrozole alone or with gonadotropin as OI protocol enrolled. Accordingly, the study group divided into two: Group A (letrozole group, no=99) and Group B (letrozole gonadotropin group, no=50). After triggering with human Chorionic Gonadotropin, the women in each group were randomly divided into two subgroup women with luteal phase support (LPS) and women without. The primary outcome measure was pregnancy rate.Results: The study shows that pregnancy rate was higher with letrozole group using LPS although the difference did not reach statistical significant (p=0.08). After adjustment of possible confounders; patients receiving letrozole with gonadotropin with LPS had significantly higher successful pregnancy rate.Conclusion: Administration of LPS after OI in infertile polycystic ovarian syndrome women may improve pregnancy rate.

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 INFLUENCE ON THE OUTCOME OF ART PROGRAMS OF FROZEN-THAWED BLASTOCYSTS EXPANDED ON FIVE OR SIX DAY

2021 ◽  
pp. 68-75
Author(s):  
A.O. Polumiskova ◽  
S.I. Tevkin ◽  
T.M. Jussubaliyeva ◽  
M.S. Shishimorova
Keyword(s):  
Pregnancy Rate ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Miscarriage Rate ◽  
Art Programs ◽  
Group A ◽  
The Difference ◽  
Group B

In order to increase the effectiveness of assisted reproductive technologies (ART) programs, it is essential to improve and develop conditions of embryo culture prior its transfer or cryopreservation of expanded blastocysts on the day 5 or 6. The aim of the study was to assess the effect of human blastocysts’ expansion timing on clinical pregnancy rate (CPR), miscarriage rate (MR) and take-home baby rate (THBR) in frozen-thawed cycles during ART programs. The study involved 2275 frozen embryo transfers (FET) of blastocysts expanded on the day 5 (group A) and 170 FET of blastocysts expanded on the day 6 (group B). The pregnancy rates in both groups were 50.8% and 46.5% respectively. There were no statistically significant differences in clinical pregnancy rate 37.4% and 37.0%, miscarriage rate 26.0% and 21.5% in both groups, respectively. THBR, as the main indicator of efficiency in the programs with transfer of post thawed expanded blastocysts on the day 5 (group A) or 6 (group B) were 36.5% and 35.2%, respectively (the difference is insignificant). In conclusion, in cryoprotocols the day of blastocyst expansion (day 5 or 6 of development) does not statistically affect PR, MR and THBR. In FET programs the quality of blastocyst (excellent and good) should be prioritized regardless of the day of cryopreservation.

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 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 Contribution to More Patient-Friendly ART Treatment: Efficacy of Continuous Low-Dose GnRH Agonist as the Only Luteal Support—Results of a Prospective, Randomized, Comparative Study

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Céline Pirard ◽  
Ernest Loumaye ◽  
Pascale Laurent ◽  
Christine Wyns
Keyword(s):  
Gnrh Agonist ◽  
Luteal Phase ◽  
Pregnancy Rates ◽  
Human Menopausal Gonadotropin ◽  
Luteal Support ◽  
Luteal Phase Support ◽  
Parallel Group ◽  
Group A ◽  
Group B ◽  
Estradiol Levels

Background. The aim of this pilot study was to evaluate intranasal buserelin for luteal phase support and compare its efficacy with standard vaginal progesterone in IVF/ICSI antagonist cycles.Methods. This is a prospective, randomized, open, parallel group study. Forty patients underwent ovarian hyperstimulation with human menopausal gonadotropin under pituitary inhibition with gonadotropin-releasing hormone antagonist, while ovulation trigger and luteal support were achieved using intranasal GnRH agonist (group A). Twenty patients had their cycle downregulated with buserelin and stimulated with hMG, while ovulation trigger was achieved using 10,000 IU human chorionic gonadotropin with luteal support by intravaginal progesterone (group B).Results. No difference was observed in estradiol levels. Progesterone levels on day 5 were significantly lower in group A. However, significantly higher levels of luteinizing hormone were observed in group A during the entire luteal phase. Pregnancy rates (31.4% versus 22.2%), implantation rates (22% versus 15.4%), and clinical pregnancy rates (25.7% versus 16.7%) were not statistically different between groups, although a trend towards higher rates was observed in group A. No luteal phase lasting less than 10 days was recorded in either group.Conclusion. Intranasal administration of buserelin is effective for providing luteal phase support in IVF/ICSI antagonist protocols.

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 Comparison of Myoinositol versus Combination of Metformin and Myoinositol in Ovulation Induction in Polycystic Ovarian Syndrome

2021 ◽  
Vol 15 (6) ◽  
pp. 1494-1496
Author(s):  
T. Akhtar ◽  
F. Shaikh ◽  
Basma . ◽  
W. U. N. Ahmed ◽  
S. Lashari ◽  
...  
Keyword(s):  
Ovulation Induction ◽  
Polycystic Ovarian Syndrome ◽  
Transvaginal Ultrasound ◽  
Clinical History ◽  
Insulin Sensitizer ◽  
Group A ◽  
Physical Examinations ◽  
The Difference ◽  
Group B ◽  
Ovarian Syndrome

Objective: To compare the efficacy of insulin sensitizer myoinositol versus a combination of myoinositol plus metformin for ovulation induction in polycystic ovarian syndrome. Study Design: Prospective, randomize control trail. Place & Duration of Study: Department of Obstetrics & Gynaecology, Sheikh Zayed Women Hospital Larkana from 1st January 2017 to 31st December 2017. Methodology: Sixty patients were recruited. The proper clinical history, demographic and physical examinations were recorded. Sixty patient divided in two groups A and B, each group receive 30 patients. Group A received myoinositol 1 gm twice daily plus ovulation (letrozole +gonadotrophin) and Group B received two insulin sensitizer myoinositol and metformin plus ovulation induction protocol(from 2-6 days and 7-9 days. Transvaginal ultrasound performed on day 12 of all patients to see the follicular size. Results: Mean age of participants was 26.4±4.4 years and LH/FSH ratio was >1.5. Oligomenorrhea, infertility, hirsutism, and overweight were the major clinical manifestation of women with PCOs. Twenty nine women with PCOs of group A (metformin plus myoinositol) were increased number of follicles as compared to women of group B (myoinositol alone), the difference was statistically significant (p<0.05). Conclusion: The combination of these two drugs ‘Metformin and Myoinositol’, work synergistically that gives more metabolic and reproductive benefits as compared to single drug work alone. Keywords: Polycystic ovarian syndrome, Ovulation, Metformin, Myoinositol, Insulin sensitivity

scholarly journals Myoinositol with Metformin and Myoinositol alone in infertile PCOS women undergoing ovulation induction cycles: A comparative study

2021 ◽  
pp. 1-10
Author(s):  
Pramod Gade ◽  
Aher Gautam S ◽  
Vazifdar Sharmeen
Keyword(s):  
Pregnancy Rate ◽  
Prospective Observational Study ◽  
Outcome Measure ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Single Drug ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Hormonal Levels

Background: This was a prospective observational study conducted over a twelve-month duration in our institute to compare the combined effect of metformin and myoinositol with metformin alone. Method: A total of sixty patients were included in the study, and they were divided into two groups depending on whether they were given the combination or the single drug. Group A (n=30) was given Myoinositol 600 mg+Metformin 500 mg thrice a day, and Group B ( n=30) was given only Myoinositol 600 mg thrice a day. The outcome measure was clinical pregnancy rate and improvement in clinical and hormonal parameters after drug therapy. Results: BMI (p<0.01), modified Ferriman Gallaway score (p>0.05), and the was a significant improvement in the hormonal parameters (LH,FSH) in both the groups and the levels were found to be comparable after a period of 6 months. The clinical pregnancy rate after six cycles of ovulation was significantly higher in Group A as compared to Group B. In Group A, the total clinical pregnancy rate was 43.33%, and in Group B, it was 26.67%, respectively, and the end of 6 months and the difference was statistically significant (p = <0.01) Conclusion: Equal response in reduction of hormonal levels and clinical and laboratory parameters were seen in both groups, while better results in terms of clinical fertility rates were observed in the group that was given a combination of myoinositol with metformin.

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 Efficacy of growth hormone in improving the pregnancy rate in poor responders in ART

2017 ◽  
Vol 6 (7) ◽  
pp. 2883
Author(s):  
Nisha E. ◽  
Sunitha H. B. ◽  
Vidya V. Bhat ◽  
K. M. Guddy
Keyword(s):  
Growth Hormone ◽  
Pregnancy Rate ◽  
Statistical Significance ◽  
Pregnancy Rates ◽  
P Value ◽  
Poor Responders ◽  
High Dose ◽  
Group A ◽  
The Difference ◽  
Group B

Background: Poor responders impose a great challenge to ART clinicians. Research to improve their pregnancy rate is going on. This study was conducted to analyze the effect of growth hormone in poor responders in ART.Methods: This study was done from January 2015 to December 2015. It was a retrospective, single centre, cohort study in which 36 poor responders were selected and allotted into group A (18) with growth hormone and group B (18) without growth hormone. High dose of gonadotrophins was used for ovarian stimulation and antagonist protocol was followed in all patients. Group A received 4 IU of growth hormone along with usual treatment from day 2 till ovulation trigger with HCG injection, group B usual protocol.Results: Statistical analysis was done with independent T test, and p value <0.05 was considered significant. Higher number of mature oocytes and pregnancy rates were observed in growth hormone group. Number of MII oocytes was 5.8, on an average in group A and 3.7 in group B, the difference was statistically significant (p 0.0000001).  Clinical pregnancy rates were 27.7% in group A and 16.6% in group B, statistical significance (p 0.02).Conclusions: Addition of growth hormone shows increase in number of oocytes retrieved and pregnancy rates in poor responders in ART patients.

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