General Gynecology and Pelvic Floor
Mahnaz Ashrafi; Behnood Farazmand; Souzan Soufizadeh Balaneji; Maryam Dadkhah
Articles in Press, Accepted Manuscript, Available Online from 01 October 2023
Abstract
Background: Polycystic ovarian syndrome (PCOS), the most common cause of infertility, is widely treated with clomiphene citrate and human gonadotropins. Letrozole, an aromatase inhibitor, can also induce ovulation in patients resistant to clomiphene. However, there has been no comprehensive study comparing ...
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Background: Polycystic ovarian syndrome (PCOS), the most common cause of infertility, is widely treated with clomiphene citrate and human gonadotropins. Letrozole, an aromatase inhibitor, can also induce ovulation in patients resistant to clomiphene. However, there has been no comprehensive study comparing ovulation induction with clomiphene and letrozole versus clomiphene and human gonadotropin. This study aimed to compare an aromatase inhibitor with human gonadotropin for patients with clomiphene-resistant polycystic ovary syndrome. Methods: This randomized clinical trial was conducted on PCOS women resistant to clomiphene at Akbarabadi hospital, Tehran, Iran. Patients were randomly divided into two groups. The first group received letrozole and clomiphene citrate and the second received clomiphene citrate and human gonadotropin.Results: Total number of 120 patients enrolled in our study. No significant difference was seen between the two groups in terms of demographic and basic clinical characteristics (P>0.05). We also found no significant difference between the two groups in terms of hirsutism, galactorrhea, pregnancy rate, human chorionic gonadotropin (HCG) intake, primary and secondary infertility, and number of follicles (P>0.05). Conclusion: The combination of letrozole and clomiphene citrate was as effective as human gonadotropin and clomiphene citrate and it could be a treatment option for patients with infertility due to PCOS.Keywords: Clomiphene, Human menopausal gonadotropin, Letrozole, Polycystic ovary syndrome, Ovulation
Obstetrics and Gynecology
Fariba Seyedoshohadaei; Masomeh Rezaie; Nasrin Sofizadeh; farnaz zandvakili; Khaled Rahmani; Hosna liravi
Articles in Press, Accepted Manuscript, Available Online from 29 November 2023
Abstract
Introduction: This study aims to determine the effectiveness of simultaneous use of aspirin with clomiphene citrate and letrozole on the success rate of ovulation induction in women with PCOS.
Materials and methods: This study was a double-blind randomized clinical trial. 120 patients with PCOS with ...
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Introduction: This study aims to determine the effectiveness of simultaneous use of aspirin with clomiphene citrate and letrozole on the success rate of ovulation induction in women with PCOS.
Materials and methods: This study was a double-blind randomized clinical trial. 120 patients with PCOS with complaints of infertility due to lack of ovulation were randomly divided into four groups using clomiphene citrate + placebo, letrozole + placebo, clomiphene citrate + Aspirin, and letrozole + aspirin divided by block randomizes. Follicometry was performed with the help of transvaginal ultrasound on the 14th day of the cycle. In the case of a positive pregnancy, the patients underwent transvaginal ultrasound in the 6th week of pregnancy to observe the gestational sac. Patients were followed up until the 12th week of pregnancy in terms of the abortion rate.
Results: This study showed that there was no significant difference in the number of follicles of 14 to 18 mm, follicles larger than 18 mm, and the thickness of the endometrium of the studied women in the four investigated groups (p>0.05). The pregnancy test results showed that the clomiphene citrate + aspirin group and the letrozole + aspirin group each had the highest pregnancy rate with 13 people (36.1%) having a positive test.
conclusion: Although the addition of aspirin to letrozole or clomiphene citrate does not affect the number of mature follicles and the thickness of the endometrium, it can increase the probability of pregnancy.
Forough Javanmanesh; Maryam Kashanian; Sara Mirpang
Volume 3, Issue 2 , May and June 2018, , Pages 49-52
Abstract
Aims: The rate of induced abortion is growing worldwide. In this study, we aimed at comparing using misoprostol with or without Letrozole in abortion.
Materials and Methods: In this placebo-controlled trial, 46 women with a gestational age of fewer than 20 weeks, who were candidates of legal abortion, ...
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Aims: The rate of induced abortion is growing worldwide. In this study, we aimed at comparing using misoprostol with or without Letrozole in abortion.
Materials and Methods: In this placebo-controlled trial, 46 women with a gestational age of fewer than 20 weeks, who were candidates of legal abortion, were selected by simple randomization sampling method and randomly assigned into two groups. Drug group received 10mg daily Letrozole (4 tablets of 2.5mg) for 3 days prior to taking Misoprostol and the placebo group received daily placebo (4 tablets with the exact appearance of Letrozole) with the same instructions. After 3 days, Misoprostol was given to all the participants based on their gestational ages. The data were analyzed by SPSS 16 software, using independent sample t-test and Chi-square test.
Findings: 21 women (45.7%) had a successful complete abortion, and curettage was needed for 25 women (54.3%). Successful abortion rate was significantly higher in the group receiving Letrozole (78.3%) than the group receiving placebo (13.0%; p=0.0001). Mean induction-abortion interval was 22.61±7.721 hours in the drug group and 24.09±8.251 hours in the placebo group, which was not significantly different (p>0.05). There was no significant difference between the two groups in terms of vaginal bleeding and adverse effects.
Conclusion: Using 10mg daily Letrozole for 3 days followed by oral Misoprostol results in a significantly higher rate of complete abortion compared with placebo in women with a gestational age of less than 20 weeks.