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Combined letrozole and clomiphene versus letrozole and clomiphene alone in infertile patients with polycystic ovary syndrome.
Drug Des Devel Ther. 2013; 7:1427-31.DD

Abstract

BACKGROUND

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of childbearing age (6.8%-18%), is among the most common causes of infertility due to ovulation factors, and accounts for 55%-70% of infertility cases caused by chronic anovulation. In this study, we used a combination of letrozole and clomiphene in patients resistant to both drugs individually, and studied the effects of this combination in ovulation and pregnancy in resistant PCOS patients.

METHODS

The study population included infertile couples diagnosed as PCOS in the wife. The women used clomiphene for at least six cycles in order to ovulate after failure to form the dominant follicle, and were then put on letrozole for four cycles. Patients who were unable to form the dominant follicle were enrolled on letrozole and clomiphene combination therapy.

RESULTS

One hundred enrolled patients underwent 257 cycles of a combination of letrozole and clomiphene, in which 213 were able to form the dominant follicle (82.9%) and 44 were unable to do so (17.1%). The number of mature follicles was 2.3±1.1. The mean endometrial thickness in patients on the day of human chorionic gonadotropin administration was 8.17±1.3 mm. The pregnancy rate was 42%.

CONCLUSION

According to the results of this study, it can be proposed that in PCOS patients resistant to clomiphene and letrozole used as single agents, a combination of the two drugs can be administered before using more aggressive treatment that may have severe complications or surgery. This combination may also be used as a first-line therapy to induce ovulation in severe cases of PCOS in order to save time and expense.

Links

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Authors+Show Affiliations

Hajishafiha M
Department of Gynecology, Reproductive Health Research Center, Urmia University of Medical Sciences, Ajman, United Arab Emirates.
Dehghan M
Urmia University of Medical Sciences, Ajman, United Arab Emirates.
Kiarang N
Department of Gynecology, Reproductive Health Research Center, Urmia University of Medical Sciences, Ajman, United Arab Emirates.
Sadegh-Asadi N
Department of Gynecology, Reproductive Health Research Center, Urmia University of Medical Sciences, Ajman, United Arab Emirates.
Shayegh SN
Gulf Medical University, Ajman, United Arab Emirates.
Ghasemi-Rad M
Urmia University of Medical Sciences, Ajman, United Arab Emirates.

MeSH

AdultAromatase InhibitorsClomipheneDrug Therapy, CombinationFemaleFertility Agents, FemaleHumansInfertility, FemaleLetrozoleNitrilesOvarian FollicleOvulation InductionPolycystic Ovary SyndromePregnancyPregnancy RateTreatment OutcomeTriazolesYoung Adult

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

24348019

Clinical Trial Links

COmbining Oral Letrozole and Clomiphene for Ovarian Stimulation
Letrozole and Sequential Clomiphene to Improve the Outcome of Embryo Transfer
COmbining Oral Letrozole and Clomiphene for Ovarian Stimulation (COOL-COS) Associated With Corifollitropin Alfa: a Pilot Study

Citation

Hajishafiha, Masomeh, et al. "Combined Letrozole and Clomiphene Versus Letrozole and Clomiphene Alone in Infertile Patients With Polycystic Ovary Syndrome." Drug Design, Development and Therapy, vol. 7, 2013, pp. 1427-31.
Hajishafiha M, Dehghan M, Kiarang N, et al. Combined letrozole and clomiphene versus letrozole and clomiphene alone in infertile patients with polycystic ovary syndrome. Drug Des Devel Ther. 2013;7:1427-31.
Hajishafiha, M., Dehghan, M., Kiarang, N., Sadegh-Asadi, N., Shayegh, S. N., & Ghasemi-Rad, M. (2013). Combined letrozole and clomiphene versus letrozole and clomiphene alone in infertile patients with polycystic ovary syndrome. Drug Design, Development and Therapy, 7, 1427-31. https://doi.org/10.2147/DDDT.S50972
Hajishafiha M, et al. Combined Letrozole and Clomiphene Versus Letrozole and Clomiphene Alone in Infertile Patients With Polycystic Ovary Syndrome. Drug Des Devel Ther. 2013;7:1427-31. PubMed PMID: 24348019.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combined letrozole and clomiphene versus letrozole and clomiphene alone in infertile patients with polycystic ovary syndrome. AU - Hajishafiha,Masomeh, AU - Dehghan,Meisam, AU - Kiarang,Nazila, AU - Sadegh-Asadi,Nahideh, AU - Shayegh,Seyed Navid, AU - Ghasemi-Rad,Mohammad, Y1 - 2013/12/03/ PY - 2013/12/19/entrez PY - 2013/12/19/pubmed PY - 2014/8/30/medline KW - clomiphene KW - combination therapy KW - infertility KW - letrozole KW - polycystic ovary syndrome SP - 1427 EP - 31 JF - Drug design, development and therapy JO - Drug Des Devel Ther VL - 7 N2 - BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of childbearing age (6.8%-18%), is among the most common causes of infertility due to ovulation factors, and accounts for 55%-70% of infertility cases caused by chronic anovulation. In this study, we used a combination of letrozole and clomiphene in patients resistant to both drugs individually, and studied the effects of this combination in ovulation and pregnancy in resistant PCOS patients. METHODS: The study population included infertile couples diagnosed as PCOS in the wife. The women used clomiphene for at least six cycles in order to ovulate after failure to form the dominant follicle, and were then put on letrozole for four cycles. Patients who were unable to form the dominant follicle were enrolled on letrozole and clomiphene combination therapy. RESULTS: One hundred enrolled patients underwent 257 cycles of a combination of letrozole and clomiphene, in which 213 were able to form the dominant follicle (82.9%) and 44 were unable to do so (17.1%). The number of mature follicles was 2.3±1.1. The mean endometrial thickness in patients on the day of human chorionic gonadotropin administration was 8.17±1.3 mm. The pregnancy rate was 42%. CONCLUSION: According to the results of this study, it can be proposed that in PCOS patients resistant to clomiphene and letrozole used as single agents, a combination of the two drugs can be administered before using more aggressive treatment that may have severe complications or surgery. This combination may also be used as a first-line therapy to induce ovulation in severe cases of PCOS in order to save time and expense. SN - 1177-8881 UR - https://www.unboundmedicine.com/medline/citation/24348019/Combined_letrozole_and_clomiphene_versus_letrozole_and_clomiphene_alone_in_infertile_patients_with_polycystic_ovary_syndrome_ DB - PRIME DP - Unbound Medicine ER -