A comparative study to evaluate the role of Letrozole and low dose human menopausal gonadotrophin on ovulation induction in polycystic ovarian syndrome patients
Keywords:
polycystic ovarian syndrome, human menopausal gonadotropin, letrozole, ovulation, pregnancyAbstract
Background: Polycystic ovarian syndrome (PCOS) is a multifaceted syndrome that affects multipleorgan systems with significant metabolic and reproductive manifestations. Treatment must be individualized on the basis of patient’s presentation, and desire for the pregnancy. Objective: To study the role of letrozole (LE) and low dose human menopausal gonadotrophen (HMG) on ovulation induction in the polycystic ovarian syndrome patients. Material & Methods: The present hospital based double blind clinical trial, recruited total 105 patients’ of age 21 to 35 years women with PCOS among those attending the gynecology outpatient’s clinic in Hind Institute of Medical Sciences Safedabad Barabanki in the period from Sept 2018 to Sept 2021 were enrolled. Observation: Endometrial thickness, and number of the mature follicles of the LE+HMG group were higher significantly than other two groups (P<0.001). Effects of different regimens on pregnancy. Pregnancy rate of LE+HMG group was 54.3%, which was insignificantly higher than LE group (31.4%) and HMG group (34.3%) (P>0.05). There were also no statistically significant differences in rate of abortion, and rates of multiple pregnancy among the three groups. All the three groups suffered from OHSS, but the incidences rates were comparable.
Downloads
References
Bacci M, Giannoni E, Fearns A, Ribas R, Gao Q, Taddei ML, et al. miR-155 drives metabolic reprogramming of ER+ breast cancer cells following long-term estrogen deprivation and predicts clinical response to aromatase inhibitors. Cancer Res. 2016; 76(6):1615-1626.
Bo HY, Chon SJ, Park JH, et al. Minimal stimulation using gonadotropin combined with clomiphene citrate or letrozole for intrauterine insemination. Yonsei Med J 2015; 56:490–6.
Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO. The prevalenceand phenotypic features of polycystic ovary syndrome: a systematic reviewand meta-analysis. Hum Reprod. 2016; 31(12):2841–55.
Budinetz TH, Benadiva CA, Griffin DW, Engmann LL, Nulsen JC, DiLuigi AJ. Ovulation rate and cycle characteristics in a subsequent clomiphene citrate cycle after stair-step protocol. FertilSteril. 2015; 103(3):675-679.
Chen Z, Zhang M, Qiao Y, Yang J. Effects of letrozole in combination with low-dose intramuscular injection of human menopausal gonadotropin on ovulation and pregnancy of 156 patients with polycystic ovary syndrome. Pak J Med Sci. 2016; 32(6):1434-1438.
D’Amato G, Caringella AM, StanzianoA, CantatoreC, Palini S and Caroppo E. Mild ovarian stimulation with letrozole plus fixed dose human menopausal gonadotropin prior to IVF/ICSI for infertile non-obese women with polycystic ovarian syndrome being pre-treated with metformin: a pilot study. Reproductive Biology and Endocrinology 2018; 16:89.
Denny L, Bhatla N. Preface for Best Practice and Research Clinical Obstetrics and Gynaecology - issue 29.6. Best Pract Res ClinObstetGynaecol. 2015; 29(6):765-766.
Ellakwa HE, Sanad ZF, Hamza HA, Emara MA, Elsayed MA.Predictors of patient responses to ovulation induction with clomiphene citrate in patients with polycystic ovary syndrome experiencing infertility.Int J Gynaecol Obstet. 2016; 133(1):59-63.
Ghosh D, Lo J, Egbuta C.Recent Progress in the Discovery of Next Generation Inhibitors of Aromatase from the StructureFunction Perspective. J Med Chem 2016; 59(11):5131-514
Hager M, HörathS, FrigoP, Koch M, Marculescu R and Ot Jt. Changes in serum markers of patients with PCOS during consecutive clomiphene stimulation cycles: a retrospective stud. ournal of Ovarian Research 2019; 12:91.
Masroor K and Maheswari B. Effect of three different doses of letrozole in ovulation induction and its effect on gonadotropins dose in unexplained infertility. International Journal of Clinical Obstetrics and Gynaecology 2020; 4(4):142-146
Palihawadana TS, Wijesinghe PS, Seneviratne HR. Factors associated with nonresponse to ovulation induction using letrozole among women with World Health Organization group II anovulation. J Hum Reprod Sci. 2015; 8(2):75-79.
Shi S, Hong T, Jiang F, Zhuang Y, Chen L, Huang X. Letrozole and human menopausal gonadotropin for ovulation induction in clomiphene resistance polycystic ovary syndrome patients: A randomized controlled study. Medicine 2020; 99:4(e18383).
Sorouri Z, Sharami SH, Tahersima Z, Salamat F. Comparison between unilateral and bilateral ovarian drilling in clomiphene citrate resistance polycystic ovary syndrome patients: A randomized clinical trial of efficacy. Int J FertilSteril. 2015; 9(1):9-16.
Suryasa, I. W., Rodríguez-Gámez, M., & Koldoris, T. (2022). Post-pandemic health and its sustainability: Educational situation. International Journal of Health Sciences, 6(1), i-v. https://doi.org/10.53730/ijhs.v6n1.5949
Tay CT, Hart RJ, Hickey M, Moran LJ, Earnest A, Doherty DA, et al. Updated adolescent diagnostic criteria for polycystic ovary syndrome: impact on prevalence and longitudinal body mass index trajectories from birth to adulthood. BMC Medicine 2020; 18:389.
Williams T, Mortada R, Porter S. Diagnosis and Treatment of Polycystic Ovary Syndrome. American Family Physician July 2016; 94(2):106-113.
Xi W, Liu S, Mao H, Yang Y, Xue X, Lu X. Use of letrozole and clomiphene citrate combined with gonadotropins in clomiphene-resistant infertile women with polycystic ovary syndrome: a prospective study. Drug Des DevelTher. 2015;9: 6001-6008.
Xiang X, Shankun L, Yongkang Y, 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 Dev Therap 2015; 6001–10.
Yin Q, Fischer L, Noethling C, Schaefer WR. In vitroassessment of putative antiprogestin activities of phytochemicals and synthetic UV absorbers in human endometrial Ishikawa cells. GynecolEndocrinol. 2015;31(7):578-581.
Yun BH, Chon SJ, Park JH, Seo SK, Cho S, Choi YS, et al. Minimal stimulation using gonadotropin combined with clomiphene citrate or letrozole for intrauterine insemination. Yonsei Med J. 2015; 56(2):490-496
Zhihua C, Mengzhen Z, Yuhuan Q, et al. Effects of letrozole in combination with low-dose intramuscular injection of human menopausal gonadotropin on ovulation and pregnancy of 156 patients with polycystic ovary syndrome. Pak J Med Sci 2016; 32:1434–8.
Published
How to Cite
Issue
Section
Copyright (c) 2022 International journal of health sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.
