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Letrozole and human menopausal gonadotropin for ovulation induction in clomiphene resistance polycystic ovary syndrome patients: A randomized controlled study.
Medicine (Baltimore). 2020 Jan; 99(4):e18383.M

Abstract

OBJECTIVE

To compare the effects of letrozole and human menopausal gonadotropin (HMG) in the treatment of patients with polycystic ovary syndrome (PCOS) resistant to clomiphene citrate (CC).

METHODS

A total of 96 clomiphene resistance polycystic ovary syndrome patients infertility were randomly divided into an LE group, and HMG group (n = 48). LE group orally received letrozole at 5.0 mg/d on the 3rd-5th days of menstrual cycle for 5 consecutive days, and 75 U/d HMG was given through intramuscular injection for 5 days starting from the third day of menstrual cycle in HMG group. Number of growing and mature follicles, serum E2 (pg/mL), serum P (ng/mL), endometrial thickness, occurrence of pregnancy and miscarriage were observed.

RESULTS

There was no significant difference in the number of ovulation cycles between the 2 groups (53.6% vs 64.7%, P > .05). The number of mature follicular cycles in the HMG group was higher than that of the letrozole group (P < .01). There were no significant differences in the clinical pregnancy rate (22.9% vs 27.1%, P > .05) and abortion rate (6.2% vs 10.4%, P > .05). There was no significant difference in the endometrial thickness between the 2 groups on the day of HCG injection [(9.1 ± 0.2) mm vs (10.7 ± 1.6) mm, P > .05]; the serum estradiol (E2) was lower in the letrozole group. The incidence of ovarian cysts was lower than that of HMG group (P < .05). There was2 ovarian hyperstimulation syndrome in the letrozole group; the incidence of ovarian hyperstimulation syndrome in the HMG group was 12.5%.

CONCLUSION

Letrozole-induced ovulation can obtain ovulation rate and pregnancy rate similar to gonadotropin, but reduce the risk associated with treatment. It can be used as an effective ovulation option for patients with polycystic ovary syndrome who are resistant to clomiphene.

Authors+Show Affiliations

Department of Gynecology and Obstetrics in The Fifth Affiliated Hospital.Department of Gynecology and Obstetrics in The Fifth Affiliated Hospital.Department of Gynecology and Obstetrics in The Fifth Affiliated Hospital.Department of Gynecology and Obstetrics in The Fifth Affiliated Hospital.Department of Gynecology and Obstetrics in The Fifth Affiliated Hospital.Department of Respiratory Medicine in The Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, China.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

31977842

Citation

Shi, Shaoquan, et al. "Letrozole and Human Menopausal Gonadotropin for Ovulation Induction in Clomiphene Resistance Polycystic Ovary Syndrome Patients: a Randomized Controlled Study." Medicine, vol. 99, no. 4, 2020, pp. e18383.
Shi S, Hong T, Jiang F, et al. Letrozole and human menopausal gonadotropin for ovulation induction in clomiphene resistance polycystic ovary syndrome patients: A randomized controlled study. Medicine (Baltimore). 2020;99(4):e18383.
Shi, S., Hong, T., Jiang, F., Zhuang, Y., Chen, L., & Huang, X. (2020). Letrozole and human menopausal gonadotropin for ovulation induction in clomiphene resistance polycystic ovary syndrome patients: A randomized controlled study. Medicine, 99(4), e18383. https://doi.org/10.1097/MD.0000000000018383
Shi S, et al. Letrozole and Human Menopausal Gonadotropin for Ovulation Induction in Clomiphene Resistance Polycystic Ovary Syndrome Patients: a Randomized Controlled Study. Medicine (Baltimore). 2020;99(4):e18383. PubMed PMID: 31977842.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Letrozole and human menopausal gonadotropin for ovulation induction in clomiphene resistance polycystic ovary syndrome patients: A randomized controlled study. AU - Shi,Shaoquan, AU - Hong,Ting, AU - Jiang,Fangfang, AU - Zhuang,Yuan, AU - Chen,Le, AU - Huang,Xiaoling, PY - 2020/1/25/entrez PY - 2020/1/25/pubmed PY - 2020/2/11/medline SP - e18383 EP - e18383 JF - Medicine JO - Medicine (Baltimore) VL - 99 IS - 4 N2 - OBJECTIVE: To compare the effects of letrozole and human menopausal gonadotropin (HMG) in the treatment of patients with polycystic ovary syndrome (PCOS) resistant to clomiphene citrate (CC). METHODS: A total of 96 clomiphene resistance polycystic ovary syndrome patients infertility were randomly divided into an LE group, and HMG group (n = 48). LE group orally received letrozole at 5.0 mg/d on the 3rd-5th days of menstrual cycle for 5 consecutive days, and 75 U/d HMG was given through intramuscular injection for 5 days starting from the third day of menstrual cycle in HMG group. Number of growing and mature follicles, serum E2 (pg/mL), serum P (ng/mL), endometrial thickness, occurrence of pregnancy and miscarriage were observed. RESULTS: There was no significant difference in the number of ovulation cycles between the 2 groups (53.6% vs 64.7%, P > .05). The number of mature follicular cycles in the HMG group was higher than that of the letrozole group (P < .01). There were no significant differences in the clinical pregnancy rate (22.9% vs 27.1%, P > .05) and abortion rate (6.2% vs 10.4%, P > .05). There was no significant difference in the endometrial thickness between the 2 groups on the day of HCG injection [(9.1 ± 0.2) mm vs (10.7 ± 1.6) mm, P > .05]; the serum estradiol (E2) was lower in the letrozole group. The incidence of ovarian cysts was lower than that of HMG group (P < .05). There was2 ovarian hyperstimulation syndrome in the letrozole group; the incidence of ovarian hyperstimulation syndrome in the HMG group was 12.5%. CONCLUSION: Letrozole-induced ovulation can obtain ovulation rate and pregnancy rate similar to gonadotropin, but reduce the risk associated with treatment. It can be used as an effective ovulation option for patients with polycystic ovary syndrome who are resistant to clomiphene. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/31977842/Letrozole_and_human_menopausal_gonadotropin_for_ovulation_induction_in_clomiphene_resistance_polycystic_ovary_syndrome_patients:_A_randomized_controlled_study_ DB - PRIME DP - Unbound Medicine ER -