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Use of letrozole and clomiphene citrate combined with gonadotropins in clomiphene-resistant infertile women with polycystic ovary syndrome: a prospective study.
Drug Des Devel Ther. 2015; 9:6001-8.DD

Abstract

BACKGROUND

Gonadotropin has been used to stimulate ovulation in clomiphene-resistant infertile women with polycystic ovary syndrome (PCOS), but it is associated with overstimulated cycles with the development of many follicles. The aim of the study was to evaluate the effectiveness and efficacy of letrozole and clomiphene citrate (CC) combined with human menopausal gonadotropin (HMG) in CC-resistant infertile women with PCOS.

METHODS

Ninety-four women received the letrozole + HMG, 90 women received CC + HMG, and 71 women received HMG only. All women received one treatment regimen in one treatment cycle. All patients were given HMG 75 IU on alternate days daily starting on day 3 or day 7 until the day of administration of human chorionic gonadotropin.

RESULTS

The rate of monofollicular development was 80.2% in the letrozole + HMG group, 65.3% in the CC + HMG group, and 54.7% in the HMG-only group (P<0.05 for letrozole + HMG vs the other two groups). The number of developing follicles (≥14 mm follicles) and the cycle cancellation rate due to ovarian hyperresponse were the lowest in the letrozole + HMG group, but the difference was not significant. The ovulation and pregnancy rate were similar among the three protocols. The HMG dose needed and the mean duration of treatment were significantly lower in the letrozole + HMG and CC + HMG groups compared with the HMG-only group.

CONCLUSION

Letrozole in combination with HMG is an effective protocol for reducing the risks of hyperstimulation for ovarian induction in CC-resistant women with PCOS. This combination may be more appropriate in patients who are particularly sensitive to gonadotropin.

Authors+Show Affiliations

The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an City, Shaanxi, People's Republic of China.Taian City Central Hospital, Shandong, Taian, People's Republic of China.The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an City, Shaanxi, People's Republic of China.The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an City, Shaanxi, People's Republic of China.The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an City, Shaanxi, People's Republic of China.The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an City, Shaanxi, People's Republic of China.

Pub Type(s)

Comparative Study
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26648691

Citation

Xi, Wenyan, et al. "Use of Letrozole and Clomiphene Citrate Combined With Gonadotropins in Clomiphene-resistant Infertile Women With Polycystic Ovary Syndrome: a Prospective Study." Drug Design, Development and Therapy, vol. 9, 2015, pp. 6001-8.
Xi W, Liu S, Mao H, et al. Use of letrozole and clomiphene citrate combined with gonadotropins in clomiphene-resistant infertile women with polycystic ovary syndrome: a prospective study. Drug Des Devel Ther. 2015;9:6001-8.
Xi, W., Liu, S., Mao, H., Yang, Y., Xue, X., & Lu, X. (2015). Use of letrozole and clomiphene citrate combined with gonadotropins in clomiphene-resistant infertile women with polycystic ovary syndrome: a prospective study. Drug Design, Development and Therapy, 9, 6001-8. https://doi.org/10.2147/DDDT.S83259
Xi W, et al. Use of Letrozole and Clomiphene Citrate Combined With Gonadotropins in Clomiphene-resistant Infertile Women With Polycystic Ovary Syndrome: a Prospective Study. Drug Des Devel Ther. 2015;9:6001-8. PubMed PMID: 26648691.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of letrozole and clomiphene citrate combined with gonadotropins in clomiphene-resistant infertile women with polycystic ovary syndrome: a prospective study. AU - Xi,Wenyan, AU - Liu,Shankun, AU - Mao,Hui, AU - Yang,Yongkang, AU - Xue,Xiang, AU - Lu,Xiaoning, Y1 - 2015/11/11/ PY - 2015/12/10/entrez PY - 2015/12/10/pubmed PY - 2016/9/16/medline KW - clomiphene citrate KW - combination therapy KW - human menopausal gonadotropin KW - letrozole KW - polycystic ovary syndrome SP - 6001 EP - 8 JF - Drug design, development and therapy JO - Drug Des Devel Ther VL - 9 N2 - BACKGROUND: Gonadotropin has been used to stimulate ovulation in clomiphene-resistant infertile women with polycystic ovary syndrome (PCOS), but it is associated with overstimulated cycles with the development of many follicles. The aim of the study was to evaluate the effectiveness and efficacy of letrozole and clomiphene citrate (CC) combined with human menopausal gonadotropin (HMG) in CC-resistant infertile women with PCOS. METHODS: Ninety-four women received the letrozole + HMG, 90 women received CC + HMG, and 71 women received HMG only. All women received one treatment regimen in one treatment cycle. All patients were given HMG 75 IU on alternate days daily starting on day 3 or day 7 until the day of administration of human chorionic gonadotropin. RESULTS: The rate of monofollicular development was 80.2% in the letrozole + HMG group, 65.3% in the CC + HMG group, and 54.7% in the HMG-only group (P<0.05 for letrozole + HMG vs the other two groups). The number of developing follicles (≥14 mm follicles) and the cycle cancellation rate due to ovarian hyperresponse were the lowest in the letrozole + HMG group, but the difference was not significant. The ovulation and pregnancy rate were similar among the three protocols. The HMG dose needed and the mean duration of treatment were significantly lower in the letrozole + HMG and CC + HMG groups compared with the HMG-only group. CONCLUSION: Letrozole in combination with HMG is an effective protocol for reducing the risks of hyperstimulation for ovarian induction in CC-resistant women with PCOS. This combination may be more appropriate in patients who are particularly sensitive to gonadotropin. SN - 1177-8881 UR - https://www.unboundmedicine.com/medline/citation/26648691/Use_of_letrozole_and_clomiphene_citrate_combined_with_gonadotropins_in_clomiphene_resistant_infertile_women_with_polycystic_ovary_syndrome:_a_prospective_study_ L2 - https://dx.doi.org/10.2147/DDDT.S83259 DB - PRIME DP - Unbound Medicine ER -