Abstract
Objective To examine the use of the aromatase inhibitor letrozole with FSH for ovarian stimulation in poor responders undergoing ovarian superovulation and IUI.
Design Observational cohort study as a prospective clinical trial in patients with unexplained infertility and a low response to ovarian stimulation with FSH.
Setting Two tertiary referral infertility clinics associated with the Reproductive Sciences Division, University of Toronto.
PATIENT(S): Twelve patients with unexplained infertility undergoing IUI who received FSH alone in 25 prior cycles with poor response (less than three dominant follicles).
INTERVENTION(S): Patients were offered letrozole, 2.5 mg/day from day 3-7 of the menstrual cycle with FSH (50-225 IU/day) starting on day 5-7. hCG (10,000 IU) was given when two leading follicles were >/=2 cm followed by IUI.
MAIN OUTCOME MEASURE(S): Number of mature follicles (>1.8 cm), FSH dose, endometrial thickness, and pregnancy rate.
RESULT(S): Improved response to FSH stimulation with letrozole co-treatment was evidenced by the significantly lower FSH dose associated with significantly higher number of mature follicles. During letrozole plus FSH stimulation cycles, clinical pregnancy was achieved in three cycles (21%).
CONCLUSION(S): In this preliminary report, we demonstrate a potential benefit of aromatase inhibition for improving ovarian response to FSH in poor responders.
letrozole aromatase inhibitor poor responder ovarian stimulation, aromatase inhibition FSH ovarian response IUI, Mitwally Casper letrozole poor responders infertility, letrozole FSH co-treatment unexplained infertility, poor ovarian response aromatase inhibitor adjunct therapy, letrozole ovarian superovulation intrauterine insemination, aromatase inhibitor reduce FSH dose poor responders, letrozole 2.5mg follicle stimulating hormone ovarian stimulation, poor responder IVF alternative letrozole FSH combination, aromatase inhibitor mature follicle development endometrial thickness
PMID 11937133 11937133 DOI 10.1016/s0015-0282(01)03280-0 10.1016/s0015-0282(01)03280-0
Keywords
Aromatase Inhibitors, Chorionic Gonadotropin/administration & Dosage, Cohort Studies, Endometrium/anatomy & Histology, Enzyme Inhibitors/administration & Dosage, Estradiol/blood, Female, Follicle Stimulating Hormone/administration & Dosage, Humans, Insemination, Artificial, Letrozole, Menstrual Cycle, Nitriles/administration & Dosage, Ovarian Follicle/anatomy & Histology, Ovulation Induction/methods, Pregnancy, Prospective Studies, Triazoles/administration & Dosage, Aromatase Inhibitors, Chorionic Gonadotropin, Enzyme Inhibitors, Nitriles, Triazoles, Estradiol, Letrozole, Follicle Stimulating Hormone