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Comparison of the efficacy of the aromatase inhibitor letrozole and clomiphene citrate as adjuvants to recombinant follicle-stimulating hormone in controlled ovarian hyperstimulation: a prospective, randomized, blinded clinical trial.
Fertil Steril. 2006 Nov; 86(5):1428-31.FS

Abstract

OBJECTIVE

To study the efficacy of the aromatase inhibitor letrozole as adjuvant to recombinant FSH (rFSH) in controlled ovarian hyperstimulation (COH).

DESIGN

Prospective, randomized, and blinded clinical study.

SETTING

Academic tertiary institute.

PATIENT(S)

Forty-one patients with unexplained infertility undergoing intrauterine insemination (IUI) therapy were randomized to receive either letrozole or clomiphene citrate (CC) as adjuvants to rFSH.

INTERVENTION(S)

From day 3 to 7 of the cycle 2.5 mg/d letrozole or 100 mg/d CC were administrated. All patients received 75 IU rFSH starting on day 7 of stimulation until the day of hCG administration. Ovulation was triggered with recombinant hCG (250 microg) when the leading follicle(s) reached 18 mm in diameter. A single IUI was performed 36 hours later. The luteal phase was supplemented with micronized progesterone vaginally.

MAIN OUTCOME MEASURE(S)

Ovarian stimulation response (E(2) levels and number of follicles) was our primary outcome.

RESULT(S)

There were no differences in demographic characteristics between groups. Although there was a significantly lower peak serum E(2) level in the group receiving letrozole + rFSH compared with CC + rFSH (914 +/- 187 vs. 1,207 +/- 309 pg/mL, respectively; P<.007), there were no differences in the number of mature (>16 mm) preovulatory follicles. A significantly higher endometrial thickness was observed at the time of hCG administration in patients that received letrozole (9.5 +/- 1.5 mm vs. 7.3 +/- 1.1 mm; P=.0001). The clinical pregnancy rate was similar between groups (23.8% vs. 20%, respectively).

CONCLUSION(S)

The aromatase inhibitor letrozole appears to constitute a good alternative to CC in patients with unexplained infertility undergoing gonadotropin-stimulated COH cycles combined with IUI therapy.

Authors+Show Affiliations

Assisted Reproductive Division, Instituto Nacional de Perinatología, Mexico City, Mexico. asistida@servidor.inper.edu.mxNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16978619

Citation

Barroso, Gerardo, et al. "Comparison of the Efficacy of the Aromatase Inhibitor Letrozole and Clomiphene Citrate as Adjuvants to Recombinant Follicle-stimulating Hormone in Controlled Ovarian Hyperstimulation: a Prospective, Randomized, Blinded Clinical Trial." Fertility and Sterility, vol. 86, no. 5, 2006, pp. 1428-31.
Barroso G, Menocal G, Felix H, et al. Comparison of the efficacy of the aromatase inhibitor letrozole and clomiphene citrate as adjuvants to recombinant follicle-stimulating hormone in controlled ovarian hyperstimulation: a prospective, randomized, blinded clinical trial. Fertil Steril. 2006;86(5):1428-31.
Barroso, G., Menocal, G., Felix, H., Rojas-Ruiz, J. C., Arslan, M., & Oehninger, S. (2006). Comparison of the efficacy of the aromatase inhibitor letrozole and clomiphene citrate as adjuvants to recombinant follicle-stimulating hormone in controlled ovarian hyperstimulation: a prospective, randomized, blinded clinical trial. Fertility and Sterility, 86(5), 1428-31.
Barroso G, et al. Comparison of the Efficacy of the Aromatase Inhibitor Letrozole and Clomiphene Citrate as Adjuvants to Recombinant Follicle-stimulating Hormone in Controlled Ovarian Hyperstimulation: a Prospective, Randomized, Blinded Clinical Trial. Fertil Steril. 2006;86(5):1428-31. PubMed PMID: 16978619.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of the efficacy of the aromatase inhibitor letrozole and clomiphene citrate as adjuvants to recombinant follicle-stimulating hormone in controlled ovarian hyperstimulation: a prospective, randomized, blinded clinical trial. AU - Barroso,Gerardo, AU - Menocal,Gerardo, AU - Felix,Hector, AU - Rojas-Ruiz,Juan Carlos, AU - Arslan,Murat, AU - Oehninger,Sergio, Y1 - 2006/09/14/ PY - 2005/06/14/received PY - 2006/03/20/revised PY - 2006/03/20/accepted PY - 2006/9/19/pubmed PY - 2006/12/9/medline PY - 2006/9/19/entrez SP - 1428 EP - 31 JF - Fertility and sterility JO - Fertil. Steril. VL - 86 IS - 5 N2 - OBJECTIVE: To study the efficacy of the aromatase inhibitor letrozole as adjuvant to recombinant FSH (rFSH) in controlled ovarian hyperstimulation (COH). DESIGN: Prospective, randomized, and blinded clinical study. SETTING: Academic tertiary institute. PATIENT(S): Forty-one patients with unexplained infertility undergoing intrauterine insemination (IUI) therapy were randomized to receive either letrozole or clomiphene citrate (CC) as adjuvants to rFSH. INTERVENTION(S): From day 3 to 7 of the cycle 2.5 mg/d letrozole or 100 mg/d CC were administrated. All patients received 75 IU rFSH starting on day 7 of stimulation until the day of hCG administration. Ovulation was triggered with recombinant hCG (250 microg) when the leading follicle(s) reached 18 mm in diameter. A single IUI was performed 36 hours later. The luteal phase was supplemented with micronized progesterone vaginally. MAIN OUTCOME MEASURE(S): Ovarian stimulation response (E(2) levels and number of follicles) was our primary outcome. RESULT(S): There were no differences in demographic characteristics between groups. Although there was a significantly lower peak serum E(2) level in the group receiving letrozole + rFSH compared with CC + rFSH (914 +/- 187 vs. 1,207 +/- 309 pg/mL, respectively; P<.007), there were no differences in the number of mature (>16 mm) preovulatory follicles. A significantly higher endometrial thickness was observed at the time of hCG administration in patients that received letrozole (9.5 +/- 1.5 mm vs. 7.3 +/- 1.1 mm; P=.0001). The clinical pregnancy rate was similar between groups (23.8% vs. 20%, respectively). CONCLUSION(S): The aromatase inhibitor letrozole appears to constitute a good alternative to CC in patients with unexplained infertility undergoing gonadotropin-stimulated COH cycles combined with IUI therapy. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/16978619/Comparison_of_the_efficacy_of_the_aromatase_inhibitor_letrozole_and_clomiphene_citrate_as_adjuvants_to_recombinant_follicle_stimulating_hormone_in_controlled_ovarian_hyperstimulation:_a_prospective_randomized_blinded_clinical_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(06)01423-3 DB - PRIME DP - Unbound Medicine ER -