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Aromatase inhibition reduces gonadotrophin dose required for controlled ovarian stimulation in women with unexplained infertility.
Hum Reprod. 2003 Aug; 18(8):1588-97.HR

Abstract

BACKGROUND

Adding clomiphene citrate (CC) to FSH for controlled ovarian stimulation (COS) decreases FSH dose required for optimum stimulation. However, because of its anti-estrogenic effects, CC may be associated with lower pregnancy rates offsetting the FSH-dose reduction benefit. Previously, we reported the success of aromatase inhibition in inducing ovulation without antiestrogenic effects.

METHODS

A prospective pilot study that included women with unexplained infertility undergoing COS and intrauterine insemination. Thirty-six women received the aromatase inhibitor letrozole + FSH, 18 women received CC + FSH and 56 women received FSH only. Each woman received one treatment regimen in one treatment cycle. All patients were given recombinant or highly purified FSH (50-150 IU/day) starting on day 3 to 7 until day of hCG.

RESULTS

The FSH dose needed was significantly lower in letrozole + FSH and CC + FSH groups compared with FSH-only without a difference in number of follicles >1.8 cm. Pregnancy rate was 19.1% in the letrozole + FSH group, 10.5% in the CC + FSH group and 18.7% in the FSH-only group. Both pregnancy rate and endometrial thickness were significantly lower in CC + FSH group compared with the other two groups. Estradiol (E2) levels were significantly lower in the letrozole + FSH group compared with the other two groups.

CONCLUSIONS

Similar to CC, aromatase inhibition with letrozole reduces FSH dose required for COS without the undesirable antiestrogenic effects sometimes seen with CC.

Authors+Show Affiliations

Samuel Lunenfeld Research Institute and Mount Sinai Hospital, Reproductive Sciences Division, Department of Obstetrics & Gynecology, University of Toronto, Toronto, Canada.No affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

12871867

Citation

Mitwally, M F M., and R F. Casper. "Aromatase Inhibition Reduces Gonadotrophin Dose Required for Controlled Ovarian Stimulation in Women With Unexplained Infertility." Human Reproduction (Oxford, England), vol. 18, no. 8, 2003, pp. 1588-97.
Mitwally MF, Casper RF. Aromatase inhibition reduces gonadotrophin dose required for controlled ovarian stimulation in women with unexplained infertility. Hum Reprod. 2003;18(8):1588-97.
Mitwally, M. F., & Casper, R. F. (2003). Aromatase inhibition reduces gonadotrophin dose required for controlled ovarian stimulation in women with unexplained infertility. Human Reproduction (Oxford, England), 18(8), 1588-97.
Mitwally MF, Casper RF. Aromatase Inhibition Reduces Gonadotrophin Dose Required for Controlled Ovarian Stimulation in Women With Unexplained Infertility. Hum Reprod. 2003;18(8):1588-97. PubMed PMID: 12871867.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Aromatase inhibition reduces gonadotrophin dose required for controlled ovarian stimulation in women with unexplained infertility. AU - Mitwally,M F M, AU - Casper,R F, PY - 2003/7/23/pubmed PY - 2004/4/16/medline PY - 2003/7/23/entrez SP - 1588 EP - 97 JF - Human reproduction (Oxford, England) JO - Hum. Reprod. VL - 18 IS - 8 N2 - BACKGROUND: Adding clomiphene citrate (CC) to FSH for controlled ovarian stimulation (COS) decreases FSH dose required for optimum stimulation. However, because of its anti-estrogenic effects, CC may be associated with lower pregnancy rates offsetting the FSH-dose reduction benefit. Previously, we reported the success of aromatase inhibition in inducing ovulation without antiestrogenic effects. METHODS: A prospective pilot study that included women with unexplained infertility undergoing COS and intrauterine insemination. Thirty-six women received the aromatase inhibitor letrozole + FSH, 18 women received CC + FSH and 56 women received FSH only. Each woman received one treatment regimen in one treatment cycle. All patients were given recombinant or highly purified FSH (50-150 IU/day) starting on day 3 to 7 until day of hCG. RESULTS: The FSH dose needed was significantly lower in letrozole + FSH and CC + FSH groups compared with FSH-only without a difference in number of follicles >1.8 cm. Pregnancy rate was 19.1% in the letrozole + FSH group, 10.5% in the CC + FSH group and 18.7% in the FSH-only group. Both pregnancy rate and endometrial thickness were significantly lower in CC + FSH group compared with the other two groups. Estradiol (E2) levels were significantly lower in the letrozole + FSH group compared with the other two groups. CONCLUSIONS: Similar to CC, aromatase inhibition with letrozole reduces FSH dose required for COS without the undesirable antiestrogenic effects sometimes seen with CC. SN - 0268-1161 UR - https://www.unboundmedicine.com/medline/citation/12871867/Aromatase_inhibition_reduces_gonadotrophin_dose_required_for_controlled_ovarian_stimulation_in_women_with_unexplained_infertility_ L2 - https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/deg311 DB - PRIME DP - Unbound Medicine ER -