EFFECT OF AROMATASE INIBITOR IN OVULATION INDUCTION IN FETILE WOMEN WITH POLYCYSTIC OVARY SYNDROME

2014 ◽  
pp. 86-93
Author(s):  
Minh Tam Le
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Ovulation Induction ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Statistical Significance ◽  
Ovulation Rate ◽  
Normal Body Mass Index ◽  
Ovary Syndrome ◽  
Group I ◽  
First Choice

Backgrounds: Polycystic Ovary Syndrome (PCOS) is one of the most common causes of female infertility due to ovulation disorders. Clomiphene citrate (CC) is a first choice to restore ovulation but it has some side effects by estrogen receptor down-regulation. Aromatase inhibitor (AI) is a newer class of drugs which increases the production of endogenous FSH to stimulate ovulation. Subjects and methods: randomized control trial to compare 64 cases of infertile women with PCOS examined at the Hue University Hospital, alternately used AI (group I) or CC (group II) for ovulation induction from day 2 cycle. Follow-up follicle growth, endometrium and ovulation via ultrasound. Evaluation were done on 10th day cycle, day of hCG trigger and after administration of hCG. Results: Total of 64 PCOS cases distributed into 2 groups using alternatively AI and CC had similar characteristics with average age of 28.8 ± 4.6, the majority were primary infertility (84.4%), infertility duration was 2.6 ± 2.4 years, 85.9% had oligomenorrhrea or amenorrhea, normal body mass index accounts for 60.9% and 21.9% was lean. Evaluation of both groups on day 10 revealed no differences in the dominant follicle and endometrial thickness. Number of days until the follicle mature appears to be shorter in AI group (15.1 ± 2.9) compared to the CC group (16.5 ± 2.8) with statistical significance. The number of mature follicles in 2 groups were not different at a rate of 81.3% (AI) and 84.4% (CC) but a higher proportion of single mature follicle in the AI ​​group (71.9%) compared with the CC group (65.7%) and There is no case with 3-4 mature follicles in the AI group. The rate of thin endometrium (<8 mm) in the AI group (25%) was lower than the CC group (53.1%) with statistically significance and higher ovulation rate (68.8%) compared with the CC group (56.3%) but have not found statistically significant. Conclusion: Two drugs AI and CC potentially induce follicle development and ovulation similarly, but AI has the potential to be more effective than CC on factors such as the shorter stimulation duration, increasing rate of single follicle, limiting multiple pregnancies, improve endometrial thickness and higher ovulation rate. More researches are needed with a larger sample size to clarify the statistical significance of differences.

scholarly journals Comparative study of clomiphene citrate versus letrozole as first-line ovulation induction drug in infertile polycystic ovary syndrome women

2020 ◽  
Vol 9 (7) ◽  
pp. 2948
Author(s):  
Mahija Sahu ◽  
Nihar Ranjan Rout
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Ovulation Rate ◽  
First Line ◽  
Ovary Syndrome ◽  
Standard Drug

Background: Polycystic ovary syndrome is the commonest endocrinopathy resulting in anovulatory infertile young women. Clomifene citrate (clomiphene) is a long-standing standard drug for ovulation induction, and is still considered as first line option in PCOS women. However, clomiphene has certain disadvantage letrozole an aromatase inhibitor acts by reducing estrogen production and has no adverse effects on endometrium and cervical mucous. Indian PCOS women have high prevalence of insulin resistance and thus are likely to have high clomiphene resistance. So letrozole could prove to be a good alternative for ovulation induction in such women.Methods: This was a prospective randomized, parallel, comparative clinical trial of two ovulation induction drugs letrozole 5 mg versus clomiphene citrate 100 mg as first-line ovulation induction drug in infertile polycystic ovarian syndrome women. The target population of the study was one hundred infertile women with PCO (taking at least 2 Rotterdam’s parameters). 50 women were allocated to clomifene citrate and 50 were allocated to Letrozole for ovulation induction. Parameters like age, duration of infertility, B MI, ovulation rate, number of follicles, pregnancy rate, endometrial thickness were noted and analyzed.Results: In letrozole group, the ovulation rate, mono-follicular development, mean endometrial thickness and pregnancy rate was better in comparison to clomifene citrate group.Conclusions: The result of this study suggests that letrozole may replace clomiphene as the first line drug for ovulation induction in infertile PCOS women.

scholarly journals Endometrial and follicular development following stair-step and traditional protocols in women with polycystic ovary syndrome: An RCT

2021 ◽  
Author(s):  
Sholeh Shahgheibi ◽  
Fariba Seyedoshohadaei ◽  
Danial Khezri ◽  
Solmaz Ghasemi
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Ovarian Follicles ◽  
Left Ovary ◽  
Ovulation Rate ◽  
Control Group ◽  
Ovary Syndrome ◽  
Significant Difference

Background: Various strategies have been proposed for polycystic ovary syndrome (PCOS) treatment. Objective: To investigate and compare the number and size of ovarian follicles, endometrial thickness, and ovulation rate by traditional protocol (TP) and stair-step protocol (SSP). Materials and Methods: Sixty infertile PCOS women were allocated into two groups (SSP = 30 and control TP = 30) between May and October 2019 in the Besat Hospital, Sanandaj, Iran. In the SSP group, the infertile women were treated with 50 mg/daily clomiphene citrate (CC) for five days, while the nonresponsive women were prescribed 100 mg daily CC for five days in the same cycle. The maximum dose (150 mg) was administered until ovulation occurred. In the control group, in non-ovulatory cases, the dose was increased in the next cycle. Ultrasound was used to detect ovulation. Results: Endometrial thickness changes with various doses of CC were significantly different in the TP. The comparison of both protocols showed a significant difference in endometrial thickness only at 50 mg CC. The number of follicles in the left ovary was significantly different in both protocols at 150-mg CC. The size of ovarian follicles in the left ovary was significantly different between the two protocols at 100-mg CC. The ovulation rate was significantly different in the SSP at 100- and 150-mg doses of CC. Moreover, 86% of ovulation occurred at 100-mg CC in the SSP, while this rate was 73% in the TP. Conclusion: The most appropriate dose for ovulation in patients with PCOS is 100 mg CC. Key words: Polycystic ovary syndrome, Clomiphene, Infertility, Ovulation induction.

scholarly journals LUARAN PEMBERIAN KLOMIFEN SITRAT BERUPA ANGKA KEBERHASILAN KEHAMILAN PADA WANITA SINDROM OVARIUM POLIKISTIK

e-CliniC ◽  
2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Irwan Syah ◽  
Maria Loho ◽  
Freddt Wagey
Keyword(s):  
Polycystic Ovary Syndrome ◽  
General Hospital ◽  
Medical Therapy ◽  
Ovulation Induction ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Reproductive Age ◽  
Ovary Syndrome ◽  
Descriptive Data ◽  
First Choice

Abstract: Polycystic ovary syndrome is the most common endocrinopathy in woman of reproductive age with an incidence that causes infertility. Woman who want to have children recomended to use ovulation induction is clomiphene citrate. Expected with the use of clomiphene citrate as first choice therapy has significcant numbers so that the use of drugs is always preffered. Purpose of this research to determine the number of pregnancies in patient with polycystic ovary syndrome with clomiphene citrate. Method used a retrospective descriptive, data of patient who treatment polycystic ovary syndrome in Prof. Dr. R. D. Kandou General Hospital Manado and practice clinical doctor conducted in the form medical therapy with clomiphene citrate. Polycystic ovary syndorme found 35 cases in the year 2012-2014 with 2 cases in Prof. Dr. R. D. Kandou General Hospital Manado and 33 cases in practice clinical doctor. Conceive with clomiphene citrate therapy were 9 people. Available data show clomiphene citrate still as the first choice drug for ovulation induction of polycystic ovary syndrome.Keywords: polycystic ovary syndrome, clomiphene citrate, succsesful, pregnancyAbstrak: Sindrom ovarium polikistik merupakan salah satu endokrinopati paling umum pada wanita usia reproduksi dengan angka kejadian yang menyebabkan infertilitas. Wanita yang ingin mempunyai anak direkomendasikan untuk induksi ovulasi adalah klomifen sitrat. Diharapkan dengan pemberian klomifen sitrat sebagai terapi pilihan pertama mempunyai angka bermakna sehingga penggunaan obat selalu diutamakan. Tujuan Penilitian ini untuk mengetahui jumlah kehamilan pada penderita sindrom ovarium polikistik dengan terapi klomifen sitrat. Metode yang digunakan bersifat retrosepktif deskriptif, data penderita sindrom ovarium polikistik yang berobat di RSUP Prof. Dr. R. D. Kandou Manado dan dokter praktek klinik yang dilakukan terapi berupa klomifen sitrat. Ditemukan 35 kasus sindrom ovarium polikistik dari tahun 2012-2014 dengan 2 kasus terdapat di RSUP Prof Dr. R. D. Kandou dan 33 kasus di dokter praktek klinik. Berhasil hamil dengan terapi klomifen sitrat sebanyak 9 orang. Data yang ada menunjukan klomifen sitrat masih sebagai pilihan pertama obat induksi ovulasi bagi penderita sindrom ovarium polikistik.Kata kunci: sindrom ovarium polikistik, klomifen sitrat, keberhasilan, kehamilan

scholarly journals Smoking as a risk factor for the development of polycystic ovary syndrome

2019 ◽  
Vol 87 (3) ◽  
pp. 56-61
Author(s):  
S.V. Gunkov ◽  
S.I. Reheda
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Inductively Coupled Plasma ◽  
Polycystic Ovary ◽  
Statistical Significance ◽  
Statistical Processing ◽  
Serum Levels ◽  
Control Group ◽  
Ovary Syndrome ◽  
Inductively Coupled ◽  
Group I

ABSTRACT. Objective. To study the prevalence of smoking among women with polycystic ovary syndrome (PCOS), as well as to establish the relationship between intensity, duration of smoking and serum levels of manganese and nickel. Materials and methods. A questionnaire survey was performed in two groups of women: the control group (I) included 38 healthy women, and the second group included 52 women with PCOS. In both groups, serum levels of manganese and were determined using inductively coupled plasma mass spectrometry. Statistical processing of the results of the survey was conducted using Statistika 8 software program. The U-Mann-Whitney test was used to assess the statistical significance of the obtained results. Comparison of the prevalence of smoking in both groups was performed using the parameter of statistical significance of differences for two relative values. Spearman coefficient was used for correlation analysis. Results. In women with PCOS, significantly higher manganese (p = 0.0012) and nickel (p = 0.0000) serum levels were found. In group I, 3 women reported smoking, in group II — 13 women. Among women with PCOS, the prevalence of smoking was significantly higher (p = 0.0000). Both groups differ neither in duration (p = 0.9463) nor in intensity of smoking (p = 0.7366). Duration and intensity of smoking were not associated with serum manganese. The intensity of smoking also did not affect serum levels of nickel. A positive correlation was found between serum nickel and the duration of smoking. Authors believe that during smoking manganese directly penetrates cerebral structures via olfactory rout. Only its small portion penetrates the bloodstream. This explains the high toxicity of manganese. Conclusion. Among women with PCOS smoking is much more common, however, the intensity and duration of smoking do not differ from the control group. Serum manganese levels are associated neither with duration nor with the intensity of smoking. Serum nickel levels are affected by the duration of smoking, rather than by the intensity of smoking. Keywords: polycystic ovary syndrome, intensity of smoking, duration of smoking, manganese, nickel.

scholarly journals Thyroxine Supplementation May Improve Ovulation and Pregnancy Rates in Infertile Patients with Polycystic Ovary Syndrome and Subclinical Hypothyroidism

2019 ◽  
Vol 3 (2) ◽  
pp. 01-05
Author(s):  
Hesham Ammar
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Subclinical Hypothyroidism ◽  
Ovulation Induction ◽  
Prospective Observational Study ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Pregnancy Rates ◽  
Ovary Syndrome ◽  
Infertile Patients

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.

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