Document Detail

Aromatase inhibition reduces gonadotrophin dose required for controlled ovarian stimulation in women with unexplained infertility.
MedLine Citation:
PMID:  12871867     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Adding clomiphene citrate (CC) to FSH for controlled ovarian stimulation (COS) decreases FSH dose required for optimum stimulation. However, because of its anti-estrogenic effects, CC may be associated with lower pregnancy rates offsetting the FSH-dose reduction benefit. Previously, we reported the success of aromatase inhibition in inducing ovulation without antiestrogenic effects. METHODS: A prospective pilot study that included women with unexplained infertility undergoing COS and intrauterine insemination. Thirty-six women received the aromatase inhibitor letrozole + FSH, 18 women received CC + FSH and 56 women received FSH only. Each woman received one treatment regimen in one treatment cycle. All patients were given recombinant or highly purified FSH (50-150 IU/day) starting on day 3 to 7 until day of hCG. RESULTS: The FSH dose needed was significantly lower in letrozole + FSH and CC + FSH groups compared with FSH-only without a difference in number of follicles >1.8 cm. Pregnancy rate was 19.1% in the letrozole + FSH group, 10.5% in the CC + FSH group and 18.7% in the FSH-only group. Both pregnancy rate and endometrial thickness were significantly lower in CC + FSH group compared with the other two groups. Estradiol (E2) levels were significantly lower in the letrozole + FSH group compared with the other two groups. CONCLUSIONS: Similar to CC, aromatase inhibition with letrozole reduces FSH dose required for COS without the undesirable antiestrogenic effects sometimes seen with CC.
M F M Mitwally; R F Casper
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  18     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-07-21     Completed Date:  2004-04-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  1588-97     Citation Subset:  IM    
Samuel Lunenfeld Research Institute and Mount Sinai Hospital, Reproductive Sciences Division, Department of Obstetrics & Gynecology, University of Toronto, Toronto, Canada.
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MeSH Terms
Aromatase Inhibitors*
Clomiphene / administration & dosage
Enzyme Inhibitors / administration & dosage
Estradiol / blood
Fertility Agents, Female / administration & dosage
Follicle Stimulating Hormone, Human / administration & dosage*
Infertility, Female / blood,  drug therapy*,  ultrasonography
Luteinizing Hormone / blood
Nitriles / administration & dosage
Ovarian Follicle / drug effects,  ultrasonography
Ovulation Induction / methods*
Pilot Projects
Prospective Studies
Triazoles / administration & dosage
Reg. No./Substance:
0/Aromatase Inhibitors; 0/Enzyme Inhibitors; 0/Fertility Agents, Female; 0/Follicle Stimulating Hormone, Human; 0/Nitriles; 0/Triazoles; 112809-51-5/letrozole; 50-28-2/Estradiol; 9002-67-9/Luteinizing Hormone; 911-45-5/Clomiphene
Comment In:
Hum Reprod. 2003 Aug;18(8):1598-602   [PMID:  12871868 ]

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