Letrozole versus Gonadotropin in Unexplained Infertile Couples Failed to Conceive with Clomiphene Citrate
Read full paper at:
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=48154#.VEXyMVfHRK0
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=48154#.VEXyMVfHRK0
Author(s)
Obstetrics and Gynecology Department, Faculty of Medicine, Zagazig University,
Ash Sharqiyah, Egypt.
Obstetrics and Gynecology Department, Faculty of Medicine, Zagazig University, Ash Sharqiyah, Egypt.
Obstetrics and Gynecology Department, Faculty of Medicine, Zagazig University, Ash Sharqiyah, Egypt.
Obstetrics and Gynecology Department, Faculty of Medicine, Zagazig University, Ash Sharqiyah, Egypt.
Obstetrics and Gynecology Department, Faculty of Medicine, Zagazig University, Ash Sharqiyah, Egypt.
Obstetrics and Gynecology Department, Faculty of Medicine, Zagazig University, Ash Sharqiyah, Egypt.
Obstetrics and Gynecology Department, Faculty of Medicine, Zagazig University, Ash Sharqiyah, Egypt.
Obstetrics and Gynecology Department, Faculty of Medicine, Zagazig University, Ash Sharqiyah, Egypt.
Obstetrics and Gynecology Department, Faculty of Medicine, Zagazig University, Ash Sharqiyah, Egypt.
Background: Unexplained
infertility represents about 15% - 20% of infertile couples. Usually, these
cases need assistance. Clomiphene citrate is the most used drug for this
problem but sometimes pregnancy failed to achieve it, so other options for
assistance are gonadotrophin or letrezole. The objective of our study was to
compare the pregnancy rate for letrezole and gonadotropin inunexplained infertile
women’s who failed to conceive with clomiphene citrate. Methods: This
prospective quasi-randomized trial was carried out in cytogenetic unite at
obstetrics and gynecology department, Zagazig University Hospital. 140
infertile females were included, induction of ovulation by letrozole for half
of them and by gonadotrophin for the other half. Results: There was
statistically highly significant decrease in duration of stimulation, E2 levels
and endometrial thickness at day of HCG in letrezole group, no significant
difference between two groups as regard number of follicles and pregnancy rate
per cycle, while the cumulative pregnancy rate and the cost of stimulation are
significantly higher in gonadotrophin group. Conclusion: In patient with
unexplained infertility who failed to conceive with clomiphene citrate,
gonadotrophins have a higher pregnancy rate than letrezole. However, pregnancy
rate was high enough with lower cost with letrezole to be acceptable and
justified its use in this group of patients.
KEYWORDS
Cite this paper
Ibrahaiem, M. , Shazly, S. , Helal, K. , Mowafy, H.
and El Behery, M. (2014) Letrozole versus Gonadotropin in
Unexplained Infertile Couples Failed to Conceive with Clomiphene
Citrate. Open Journal of Obstetrics and Gynecology, 4, 636-641. doi: 10.4236/ojog.2014.410088.
| [1] | Quaas, A. and Dokras, A. (2008) Diagnosis and Treatment of Unexplained Infertility. Reviews in Obstetrics Gynecology, 1, 69-76. |
| [2] | Mukherjee, S., Sharma, S. and Chakravarty, B.N. (2010) Comparative in Polycystic Ovarian Syndrome and Unexplained Infertility—A Prospective Clinical Trial. Journal of Human Reproductive Sciences, 3, 80-84. http://dx.doi.org/10.4103/0974-1208.69341 |
| [3] | Ehert, P., Schertz, C.J. and Ezcurra, D. (2010) Recombinant Human Follicle-Stimulating Hormone Produces More Oocytes with a Lower Total Dose per Cycle in Assisted Reproductive Technologies Compared with Highly Purified Human Menopausal Gonadotrophin: A Meta-Analysis. Reproductive Biology and Endocrinology, 8, 112. http://dx.doi.org/10.1186/1477-7827-8-112 |
| [4] | Menkveld, R. (2010) Clinical Significance of the Low Normal Sperm Morphology Value as Proposed in the Fifth Edition of the WHO Laboratory Manual for the Examination and Processing of Human Semen. Asian Journal of Andrology, 12, 47-58. |
| [5] |
Kamath, M.S. and George, K.
(2011) Letrozole or Clomiphene Citrate as First Line for Anovulatory
Infertility: A Debate. Reproductive Biology and Endocrinology, 9, 86-88.
http://dx.doi.org/10.1186/1477-7827-9-86 |
| [6] | Sarhan, A., Beydoun, H., Jones, H.W. and Bocca, S. (2011) Gonadotrophin Ovulation Induction and Enhancement Outcomes: Analysis of More Than 1400 Cycles. Reproductive BioMedicine Online, 23, 220-226. http://dx.doi.org/10.1016/j.rbmo.2011.05.002 |
| [7] |
Mitwally, M.F., Biljan, M.M. and
Casper, R.F. (2005) Pregnancy Outcome after the Use of an Aromatase
Inhibitor for Ovarian Stimulation. American Journal of Obstetrics
Gynecology, 192, 381-386.
http://dx.doi.org/10.1016/j.ajog.2004.08.013 |
| [8] | Ganesh, A., Goswami, S.K., Chattopadhyay, R., et al. (2009) Comparison of Letrozole with Continuous Gonadotropins and Clomiphene-Gonadotropin Combination for Ovulation Induction in 1387 PCOS Women after Clomiphene Citrate Failure; A Randomized Prospective Clinical Trial. Journal of Assisted Reproduction and Genetics, 26, 19-24. |
| [9] |
Mukherjee, S., Sharma, S. and
Nath Chakravarty, B. (2012) Letrozole in a Low-Cost in Vitro
Fertilization Protocol in Intracytoplasmic Sperm Injection Cycles for
Male Factor Infertility: A Randomized Controlled Trial. Journal of Human
Reproductive Sciences, 5, 170-174. http://dx.doi.org/10.4103/0974-1208.101014 |
| [10] |
Gregoriou, O., Vlahos, N.F. and
Konidaris, S. (2008) Randomized Controlled trial Comparing
Superovulation with Letrozole versus Recombinant Follicle-Stimulating
Hormone Combined with Intrauterine Insemination for Couples with
Unexplained Infertility Who Had Failed Clomiphene Citrate Stimulation
and Intrauterine Insemination. Fertility and Sterility, 90, 678-683. http://dx.doi.org/10.1016/j.fertnstert.2007.06.099 |
| [11] | HaqNawaz, F., Virk, S., Qadir, T. and Imam, S. (2013) Comparison of Letrozole and Clomiphene Citrate Efficacy along with Gonadotrophins in Controlled Ovarian Hyperstimulation for Intrauterine Insemination Cycles. Journal of Reproduction and Infertility, 14, 138-142. |
| [12] | Quintero, R.B., Urban, R., Lathi, R.B. and Westphal, L.M. (2007) A Comparison of Letrozole to Gonadotropins for Ovulation Induction, in Subjects Who Failed to Conceive with Clomiphene Citrate. Fertility and Sterility, 88, 879-885. http://dx.doi.org/10.1016/j.fertnstert.2006.11.166 |
| [13] | Healey, S., Tan, S.L., Tulandi, T. and Biljan, M.M. (2003) Effects of Letrozole on Superovulation with Gonadotropins in Women Undergoing Intrauterine Insemination. Fertility and Sterility, 80, 1325-1329. http://dx.doi.org/10.1016/j.fertnstert.2003.03.001 |
| [14] |
Baysoy, A., Serdaroglu, H. and
Jamal, H. (2006) Letrozole versus Human Menopausal Gonadotrophin in
Women Undergoing Intrauterine Insemination. Reproductive BioMedicine
Online, 13, 208-212.
http://dx.doi.org/10.1016/S1472-6483(10)60617-7 |
| [15] | Speroff, L. and Fritz, M.A. (2005) Induction of Ovulation in Clinical Gynecologic Endocrinology and Infertility. 7th Edition, Lippincott, Williams & Wilkins, Philadelphia, 250-255. |
| [16] |
Polyzos, N.P., Tzioras, S. and
Badawy, A.M. (2009) Aromatase Inhibitors for Female Infertility: A
Systematic Review of the Literature. Reproductive BioMedicine Online,
19, 456-471. http://dx.doi.org/10.1016/j.rbmo.2009.06.008 eww141021lx |
评论
发表评论