Role of Letrozole in Management of Female Infertility; Review Article

Background: Letrozole is a highly steroidal and selective oral aromatase inhibitor (AI). Serval studies shows that Co-treatment with letrozole significantly reduced gonadotropin consumption and the incidence of Ovarian Hyperstimulation Syndrome in normal/high responders, with pregnancy outcomes comparable to or better than the other groups. In this article we will be looking at role of letrozole in treatment of infertility Methodology: A simple systematic review was carried out, searching databases PubMed, Google Scholar, and EBSCO. The authors extracted qualitative data, and then the author's names, year, study type, methodology, and the result were reported. Results and Conclusion: Letrozole has effectiveness which is near the usage of the Human Menopausal Gonadotrophin in the numbers of pregnancies per cycle but have much less cost which indicates cost effectiveness of the drug. Furthermore, studies show that administration of the drug is effective in inducing pregnancy, with higher dose more than 5mg and 7.5mg more effective.

Prediction of Patients with Ovarian Hyperstimulation Syndrome in Gnrh-A Prolonged Protocol : A Retrospective Study

Background: OHSS (ovarian hyperstimulation syndrome) is a life-threatening complication and most common adverse effect of fertility treatmentObjectives: To investigate associated risk factors of ovarian hyperstimulation syndrome (OHSS) in stimulated ovarian cycles with assisted reproductive technology, may provide guidance for clinicians on how to prevent OHSS. Methods: A Logistic regression analysis was conducted in 336 patients who had completed IVF-ICSI/ET cycles between April 2019 and April 2020 in the first affiliated hospital of kunming medical university. Receiver-operating characteristic (ROC) curves for OHSS were calculated for each predictor using cut-off values. Area under the curve (AUC) analysis and logistic regression models were performed to compare the performance of laboratory biomarkers. Results: According to clinical diagnosis, 61 cycles developed OHSS of 336 cycles, with an incidence of 18.15%. Patients were graded according to their clinical symptoms and severity, including 27 cycles of moderate OHSS (8.04%) and 8 cycles of severe OHSS (2.38%). The cut-off value of AMH, E2 on HCG day, egg retrieved to predict moderate and severe OHSS were 7.495ng/ml, 4828pg/ml and 19.5 in GnRH-a Prolonged Protocol, with sensitivities of 77.0%, 67.2%, 80.3%, and specificity of 68.0%, 70.9%, 81.5% respectively. The area under the curve (AUC) values of AMH, E2 on HCG day, Number of oocytes retrieved to predict moderate and severe OHSS were 0.754, 0.738, 0.876, respectively. And the AUC value of combined index to predict moderate and severe OHSS was 0.898, achieved the highest AUC with 85.2% sensitivity and 83.6% specificity. Conclusions:AMH, E2 day of HCG and number of eggs obtained have a good predictive effect on the occurrence of OHSS, and the predictive ability is further improved after the combination of the three indicators.

Ovarian hyperstimulation syndrome: cardiac arrest with an unexpected outcome

We describe the acute deterioration of a 29-year-old undergoing in vitro fertilisation. Late-onset critical ovarian hyperstimulation syndrome triggered a massive pulmonary embolism and subsequent cardiac arrest. While the prognosis was deemed to be poor, the patient made a full recovery. The potential reasons for this are explored.