Volume 2, Issue 2 (7-2004)                   IJRM 2004, 2(2): 78-81 | Back to browse issues page

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Davar R, Aflatoonian A. The Effect of Letrozole in Induction of Ovulation in Clomiphene Resistant Patients. IJRM. 2004; 2 (2) :78-81
URL: http://ijrm.ssu.ac.ir/article-1-20-en.html
Abstract:   (2170 Views)
Background: In patients with anovulatory infertility the first choice of treatment for ovulation induction is an antiestrogen, most commonly clomiphene citrate (CC). However, 20-25% of the women are resistant to CC and do not ovulate perhaps due to antiestrogenic mechanism of the CC action, which involves long-lasting estrogen receptor (ER) depletion. Objective: The objective of the study was to mimic the action of CC without depletion of ERs by the administration of an aromatase inhibitor letrozole in a selected group of Poly Cystic Ovary (PCO) patients who demonstrated failure to ovulate after treatment with CC. Materials and Methods: 20 patients with anovulation due to polycystic ovary syndrome (PCOS), who had previously inadequately responded to CC were selected for study. The aromatase inhibitor letrozole was administered orally in a dose of 2.5 mg on days 3-7 of the menstrual cycle. Then, occurrence of ovulation, endometrial thickness, and pregnancy rates were determined. Result(s): Only one patient had one dominant follicle (1.8 cm diameter) on day 14 of the cycle (estradiol = 200 pg/ml). IUI was done; however, no pregnancy took place. In the remaining cases, several sonographies were done between days 9 to 15 of the cycle; however, all cycles were cancelled due to absence of a dominant follicle (>1.4 cm). Conclusion(s): Our study did not confirm the favorable effect of letrozole for induction of ovulation in patients with clomiphene resistant PCO. Article
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1. Bulun S. (2003) Ovulation induction in women with infertility: a new indication for aromatase inhibitors. Fertil Steril 80:1338-1339. [DOI:10.1016/j.fertnstert.2003.06.001] [PMID]
2. David T., Vander molen, Valerie S. and Ratts. (2001) Metformin increases the ovulatory rate and pregnancy rate from clomiphene citrate in patients with polycystic ovary syndrome who are resistant to clomiphene citrate alone. Fertile Steril 75: 310-314. [DOI:10.1016/S0015-0282(00)01675-7]
3. Deleo V., and Iamarca A. (1999) Effect of metformin on gonadotropin induced ovulation in women with polycystic ovary syndrome. Fertil Steril 72: 282-285. [DOI:10.1016/S0015-0282(99)00208-3]
4. Donesky B.W. and Adashi E.Y. (1996) Surgical ovulation induction: The role of ovarian diathermy in polycystic ovary syndrome. Bailliers-Clin Endocrinol Metab 10:293-309. [DOI:10.1016/S0950-351X(96)80141-8]
5. Fatemi H.M., Kolibianakis E., Tournaye H., et al. (2003) Clomiphene citrate versus letrozole for ovarian stimulation. Repro Biom online.7: 543-6. [DOI:10.1016/S1472-6483(10)62070-6]
6. Frank S. (1995) Polycystic ovary syndrome. N Engl J Med 333: 853-861. [DOI:10.1056/NEJM199509283331307] [PMID]
7. Franks S., Adams J., Mason H. and Polson D. (1985) Ovulatory disorders in women with polycystic ovary syndrome. Clin Obstet Gynecol 12: 605-632.
8. Gysler M., March C., Mishell D.J.J.R. and Bailey EJ. (1982) Adecade experience with an individualized clomiphene treatment regimen including its effects on the post coital test. Fertil Steril 37:161-167 [DOI:10.1016/S0015-0282(16)46033-4]
9. Hammond M., Halme J. and Talbert L. (1983) Factors affecting the pregnancy rate in clomiphene citrate induction of ovulation. Obstet Gynecol 62:196-202.
10. Hull M.G.R.(1992)The cause of infertility and relative effectiveness of treatment.Infertility33-62. [DOI:10.1007/978-1-4471-1962-3_3]
11. Iveson T., Smith I., Ahern J., Smithers D., Trunet P. and Dowsett M. (1993) Phase I study of oral nonsteroidal aromatase inhibitor in post menopausal patients with advanced breast cancer. Cancer Res 53: 266-270.
12. Kettel L.M., Roseff S.J., Berga S.L., Mortola J.F. and Yen S.S.C. (1993) Hypothalamic- pituitary- ovarian response to clomiphene citrate in women with polycystic ovary syndrome. Fertil Steril 59:532-538. [DOI:10.1016/S0015-0282(16)55795-1]
13. Lipton A., Demers L., Harvey H., Kambic K., Grossberg H., Brady C., et al. (1995) Letrozole: a phase I study of a new potent oral aromatase inhibitor of breast cancer. Cancer 75:2132-2138. https://doi.org/10.1002/1097-0142(19950415)75:8<2132::AID-CNCR2820750816>3.0.CO;2-U [DOI:10.1002/1097-0142(19950415)75:83.0.CO;2-U]
14. Mitwally M., and Casper F. (2001) Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate. Fertil Steril 75:305-309. [DOI:10.1016/S0015-0282(00)01705-2]
15. Mitwally M., and Casper F. (2002) Aromatase inhibition improves ovarian response to follicle stimulating hormone in poor responders. Fertil Steril 77:776-780. [DOI:10.1097/00006254-200209000-00018] [PMID]
16. Shoham Z. and Weissman A. (1998) Polycystic ovarian disease: obesity and insulin resistance. Fertility and Reproductive Medicine 263-272.
17. Tao Y. and Dai Q. (1999) Treatment of polycystic ovary syndrome and related infertility with clomiphene resistance by compound cyproterone acetate. Zhonghua Fu chan Ke 34: 528-31.

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