A randomized trial of letrozole versus clomiphene citrate in women undergoing superovulation

被引:154
作者
Al-Fozan, H [1 ]
Al-Khadouri, M [1 ]
Tan, SL [1 ]
Tulandi, T [1 ]
机构
[1] McGill Univ, Dept Obstet & Gynecol, Montreal, PQ H3A 1A1, Canada
关键词
randomized trial; letrozole; clomiphene; superovulation; ovulation;
D O I
10.1016/j.fertnstert.2004.04.070
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To compare the effects of the aromatase inhibitor letrozole (7.5 mg) and clomiphene citrate (CC; 100 mg) in women undergoing superovulation and IUI. Design: Prospective randomized trial. Setting: University teaching hospital. Patient(s): We studied a total of 238 cycles of superovulation and IUI in women with idiopathic infertility. Interventions: Patients were randomized into treatment with 7.5 mg of letrozole daily (74 patients, 115 cycles) or 100 mg of CC daily (80 patients, 123 cycles). Main Outcome Measure(s): Number of follicles, endometrial thickness, pregnancy rate, and miscarriage rate. Result(s): The mean age, parity, and duration of infertility in both groups of patients were similar. There was no significant difference between the total number of developing follicles in the letrozole (5.7 +/- 3.7) and in the CC groups (4.8 +/- 2.5). The number of follicles of greater than or equal to14 mint and of >18 mm were 2.1 +/- 1.2 and 1.4 +/- 0.7 in the letrozole group, and 1.7 +/- 0.9 and 1.1 +/- 0.5 in the CC group, respectively. No difference was found in the endometrial thickness between the two groups (7.1 +/- 0.2 mm in the letrozole group, 8.2 +/- 5.9 tram in the CC group). The pregnancy rate per cycle was 11.5% in the letrozole group and 8.9% in the CC group. Four of the 11 pregnancies in the CC group resulted in a miscarriage (36.6%). Conclusion(s): Superovulation and IUI with letrozole and CC are associated with similar pregnancy rates, but the miscarriage rate is higher with CC. The ideal dose of letrozole remains unknown and further study is needed. (C) 2004 by American Society for Reproductive Medicine.
引用
收藏
页码:1561 / 1563
页数:3
相关论文
共 20 条
[1]  
DICKEY RP, 1993, FERTIL STERIL, V59, P756
[2]  
EDEN JA, 1989, OBSTET GYNECOL, V73, P187
[3]  
FRANKS S, 1985, CLIN OBSTET GYNAECOL, V12, P605
[4]   SONOGRAPHIC DETERMINATION OF A POSSIBLE ADVERSE EFFECT OF CLOMIPHENE CITRATE ON ENDOMETRIAL GROWTH [J].
GONEN, Y ;
CASPER, RF .
HUMAN REPRODUCTION, 1990, 5 (06) :670-674
[5]   Effects of letrozole on superovulation with gonadotropins in women undergoing intrauterine insemination [J].
Healey, S ;
Tan, SL ;
Tulandi, T ;
Biljan, MM .
FERTILITY AND STERILITY, 2003, 80 (06) :1325-1329
[6]  
KETTEL LM, 1993, FERTIL STERIL, V59, P532
[7]  
Kistner R W, 1965, Obstet Gynecol Surv, V20, P873, DOI 10.1097/00006254-196512000-00001
[8]  
MIKKELSON TJ, 1986, FERTIL STERIL, V46, P392
[9]   Aromatase inhibition improves ovarian response to follicle-stimulating hormone in poor responders [J].
Mitwally, MFM ;
Casper, RF .
FERTILITY AND STERILITY, 2002, 77 (04) :776-780
[10]   Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate [J].
Mitwally, MFM ;
Casper, RF .
FERTILITY AND STERILITY, 2001, 75 (02) :305-309