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Influence of the conclusion of a recent large cooperative study in changing standard protocol of inducing menses in anovulatory women with oligomenorrhea prior to initiating ovulation induction with anti-estrogens and outcome.
- Source :
-
Clinical and experimental obstetrics & gynecology [Clin Exp Obstet Gynecol] 2017; Vol. 44 (2), pp. 180-182. - Publication Year :
- 2017
-
Abstract
- Purpose: To compare pregnancy rates following ovulation induction in anovulatory women with clomiphene citrate vs. letrozole and to determine the relative confounding effect of inducing menses or not. The study also evaluated whether starting these anti-estrogen drugs later in the menstrual cycle has-less adverse effect on endometrial thickness.<br />Materials and Methods: Prospective series with choice by physician of inducing menses or not or choosing clomiphene citrate or letrozole for ovulation induction. Peak endometrial thickness was compared between drugs and between those conceiving or not.<br />Results: There were 21 first cycles using letrozole and 42 using clomiphene. Menses were not induced in 18/21 (86%) letrozole cycles and 24/42 (57%) clomiphene cycles. Clinical pregnancies occurred in four (22.2%) letrozole cycles without induced menses with one miscarriage vs. 4/24 (16.6%) clomiphene cycles, no mis- carriage. One of three (33.3%) letrozole cycles with menses induced achieved a clinical pregnancy vs. only 1/18 (5.5%) of clomiphene cycles. There were no miscarriages.<br />Conclusions: Though the endometrial thickness was higher with clomiphene without induced menses vs. menses induced (11 mm vs. 9.5 mm), one cannot explain the trend for lower pregnancy rates in women with induced menses because of thinner endometria since the thickness was 10.3 mm for clomiphene and 10.0 with letrozole.
- Subjects :
- Adult
Estrogens pharmacology
Female
Fertility Agents, Female therapeutic use
Humans
Letrozole
Polycystic Ovary Syndrome drug therapy
Pregnancy
Pregnancy Rate
Anovulation drug therapy
Clomiphene therapeutic use
Endometrium drug effects
Endometrium pathology
Estrogen Antagonists therapeutic use
Nitriles therapeutic use
Oligomenorrhea drug therapy
Ovulation Induction methods
Triazoles therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 0390-6663
- Volume :
- 44
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Clinical and experimental obstetrics & gynecology
- Publication Type :
- Academic Journal
- Accession number :
- 29746016