scholarly journals Effect of Aromatase Inhibitors versus Clomiphene Citrate for Ovulation Induction in Infertile Women with Ovulatory Dysfunction (PCO)

2020 ◽  
Author(s):  
Hassan S.O. Abduljabbar ◽  
Magda Hagras ◽  
Rania Magadmy
Keyword(s):  
Aromatase Inhibitors ◽  
Ovulation Induction ◽  
Clomiphene Citrate ◽  
Infertile Women ◽  
Ovulatory Dysfunction

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

2021 ◽  
Vol 10 (8) ◽  
pp. 2944
Author(s):  
Sinan S. Ay ◽  
Özer Birge ◽  
Mehmet S. Bakır ◽  
Ayşe E. Yumru
Keyword(s):  
Aromatase Inhibitor ◽  
Ovulation Induction ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Ovary Syndrome ◽  
Infertile Women ◽  
Appropriate Treatment ◽  
The Mean ◽  
Infertility Patients ◽  
Infertile Patients

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.

scholarly journals Aromatase Inhibitors for Ovulation Induction

2006 ◽  
Vol 91 (3) ◽  
pp. 760-771 ◽  
Author(s):  
Robert F. Casper ◽  
Mohamed F. M. Mitwally
Keyword(s):  
Side Effects ◽  
Aromatase Inhibitors ◽  
Ovulation Induction ◽  
Assisted Reproductive Technologies ◽  
Evidence Synthesis ◽  
Clomiphene Citrate ◽  
Multiple Pregnancy ◽  
Significant Risk ◽  
Reproductive Technologies ◽  
Poor Responders

Abstract Context: For the last 40 yr, the first line of treatment for anovulation in infertile women has been clomiphene citrate (CC). CC is a safe, effective oral agent but is known to have relatively common antiestrogenic endometrial and cervical mucous side effects that could prevent pregnancy in the face of successful ovulation. In addition, there is a significant risk of multiple pregnancy with CC, compared with natural cycles. Because of these problems, we proposed the concept of aromatase inhibition as a new method of ovulation induction that could avoid many of the adverse effects of CC. The objective of this review was to describe the different physiological mechanisms of action for CC and aromatase inhibitors (AIs) and compare studies of efficacy for both agents for ovulation induction. Evidence Acquisition: We conducted a systematic review of all the published studies, both controlled and noncontrolled, comparing CC and AI treatment, either alone or in combination with gonadotropins, for ovulation induction or augmentation, identified through the Entrez-PubMed search engine. Evidence Synthesis: Because of the recent acceptance of the concept of using AIs for ovulation induction, few controlled studies were identified, and the rest of the studies were pilot or preliminary comparisons. Based on these studies, it appears that AIs are as effective as CC in inducing ovulation, are devoid of any antiestrogenic side effects, result in lower serum estrogen concentrations, and are associated with good pregnancy rates with a lower incidence of multiple pregnancy than CC. When combined with gonadotropins for assisted reproductive technologies, AIs reduce the dose of FSH required for optimal follicle recruitment and improve the response to FSH in poor responders. Conclusions: Preliminary evidence suggests that AIs may replace CC in the future because of similar efficacy with a reduced side effect profile. Although worldwide experience with AIs for ovulation induction is increasing, at present, definitive studies in the form of randomized controlled trials comparing CC with AIs are lacking.

scholarly journals Clomiphene citrate: the changing landscape

2018 ◽  
Vol 7 (8) ◽  
pp. 1437
Author(s):  
Mahesh C. Gupta ◽  
Jyoti Khanna
Keyword(s):  
Adverse Effects ◽  
Ovulation Induction ◽  
Clomiphene Citrate ◽  
Female Infertility ◽  
Racemic Mixture ◽  
Human Female ◽  
Ovulatory Dysfunction ◽  
Agonistic Activity ◽  
Potential Use ◽  
Cis Isomer

Ovulatory dysfunction is one of the leading causes of female infertility. Clomiphene citrate has emerged as a boon in the induction of ovulation in the human female. Clomiphene results in many adverse effects some of which are documented, and some reported spontaneously. Clomiphene citrate is a non-racemic mixture of two isomers, zuclomiphene and enclomiphene, having individual and opposite biological actions. It is accepted that cis isomer (zuclomiphene) is estrogenic and trans isomer (enclomiphene) is anti-estrogenic. Zuclomiphene does not have any ovulation-induction propertybut gets accumulated for a longer time in the human body and it has more agonistic activity than enclomiphene. Thus, Zuclomiphene may be responsible for the adverse effects by clomiphene citrate. Enclomiphene is being explored for its potential use in male as well as female infertility. Trails are underway to explore its effectiveness and safety in various disorders. This article highlights the pharmacology of Clomiphene with respect to its isomers and the potential uses of enclomiphene based on evidences available.

Anastrozole vs. clomiphene citrate in infertile women with ovulatory dysfunction: a phase II, randomized, dose-finding study

2011 ◽  
Vol 95 (5) ◽  
pp. 1720-1724.e8 ◽  
Author(s):  
Donald Tredway ◽  
Joan C. Schertz ◽  
Daena Bock ◽  
George Hemsey ◽  
Michael P. Diamond
Keyword(s):  
Phase Ii ◽  
Clomiphene Citrate ◽  
Dose Finding ◽  
Infertile Women ◽  
Ovulatory Dysfunction ◽  
Finding Study ◽  
Dose Finding Study

scholarly journals A randomised clinical trial comparing myoinositol and metformin in PCOS

2017 ◽  
Vol 6 (5) ◽  
pp. 1814 ◽  
Author(s):  
Kishan Chirania ◽  
Sujata Misra ◽  
Sandhya Behera
Keyword(s):  
Insulin Resistance ◽  
Ovulation Induction ◽  
Clomiphene Citrate ◽  
Randomised Clinical Trial ◽  
Ovarian Dysfunction ◽  
Menstrual Cycles ◽  
Infertile Women ◽  
Symptom Profile ◽  
Obstetrics And Gynaecology ◽  
Definitive Role

Background: The medical management of PCOS is fast changing from the combination hormonal pills/progesterone for cycle regularisation, cosmetological treatment of acne and hirsutism to management of obesity and insulin resistance. This study evaluates the effects of the insulin sensitisers in improving the clinical and hormonal alterations in cases of PCOS and improving the reproductive outcomes.Methods: This 3-arm prospective randomized comparative study was done from August 2015 to July 2016 in the Department of Obstetrics and Gynaecology at SCB MCH, Cuttack wherein patients of PCOS were studied based on treatment with metformin, myoinositol or both.Results: Myoinositol helped in the resumption of spontaneous menstrual cycles in 66.66% of women with PCOS with menstrual complaints, whereas the same effect in patients who took metformin was only in 15.78%, which was not significant. Use of myoinositol in Infertile women with PCOS resulted in a pregnancy in 57.14% of women, without the need of any ovulation inducing agent while use of metformin gave a pregnancy in all the 9 patients, thought 5 out of them required clomiphene citrate for ovulation induction. With myoinositol there was a reduction in weight, BMI, LH/FSH ratio, acne and hirsutism. Metformin has resulted in a decrement of body weight, BMI and acne only.Conclusions: This study conclusively proves that myoinositol has a definitive role in decreasing the ovarian dysfunction of PCOS. There has been a significant improvement in the symptom profile, weight loss and a significant change in the hormonal parameters.

scholarly journals A study of comparison of effectiveness of letrozole (5mg) versus clomephene citrate (100 mg) for ovulation induction among infertile women

2021 ◽  
Vol 8 (4) ◽  
pp. 553-558
Author(s):  
Manish R Pandya ◽  
Khushbu Patel
Keyword(s):  
Aromatase Inhibitor ◽  
Ovulation Induction ◽  
Polycystic Ovarian Syndrome ◽  
Clomiphene Citrate ◽  
Estradiol Valerate ◽  
Infertile Women ◽  
Group A ◽  
Group B ◽  
Ovarian Syndrome ◽  
Anovulatory Infertility

Clomiphene citrate has been traditionally used as the drug of the choice for treatment of women with anovulatory infertility. In the last decade, an aromatase inhibitor, letrozole has emerged as an alternative ovulation induction agent among anovulatory women with polycystic ovarian syndrome. Letrozole has a definitive role in anovulatory women who have not responded to the clomiphene citrate therapy is confirmed by literatures. Anovulatory dysfunction is a common problem and is responsible for about 40% of female infertility and among causes; PCOS (polycystic ovarian syndrome) is the leading cause. Clomiphene citrate is considered as the drug of choice for the first line treatment of anovulatory dysfunction for a variety of reasons. Clomiphene citrate has some side effects like multi-follicular development and cyst formation and resistance of clomiphene are areas of concern and desire for an effective alternative persists.An aromatase inhibitor, letrozole, was introduced into infertility practice in the year 2000 and is regarded as a second line option, particularly in women with clomiphene resistance, and it has found acceptance in various clinical situations and the indications for use have expanded., To compare the efficacy of letrozole and clomiphene citrate (CC) for ovulation induction in infertile women. The study included 100 women presented with anovulatory infertility. The infertile women were divided into 2 groups of 50: Group A received 100 mg Clomiphene Citrate from day 3 to day 5 of menstruation and Estradiol Valerate 4 mg on the 12 day of menstruation until 16 day of menstruation; Group B treated by 5 mg Letrozole from day 3 to day 5 of the menstruation and as Group A, Estradiol Valerate 4 mg on the 12 day of menstruation until 16 day of menstruation given to Group B, with visits to determine ovulation and pregnancy, followed by tracking of pregnancies. Participants were of 20 to 39 years age, had normal uterine cavity and had a male partner with a sperm concentration of at least 14 million per millilitre; and during the study the women and their partners agreed to have regular intercourse with the intent of conception. The live birth during the treatment period was the primary outcome. Women who received letrozole had more cumulative live births than those women who had received clomiphene citrate (36 out of 50 [72%] vs. 28 out of 50 [56%]), without significant differences in overall congenital anomalies, there were no congenital anomalies. With letrozole as compared to clomiphene the cumulative ovulation rate was higher. Higher incidence of hot flushes was associated with a clomiphene, and letrozole was associated with fatigue and dizziness. Rates of other adverse effects were almost similar among these 2 groups. A significant difference in the follicular and endometrial development was evident among these 2 groups. As compared to with clomiphene, an aromatase inhibitor, letrozole was associated with higher live-birth and ovulation rates among infertile women. The results of the study demonstrated letrozole to be superior to clomiphene citrate in the maintenance of endometrial thickness.

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