Articles

Comparison of Treatment Outcomes of Infertile Women by Clomiphene Citrate and Letrozole with Gonadotropins Underwent Intrauterine Insemination

Abstract

This study was designed to compare the effect of clomiphene and letrozole in ovulatory stimulation in infertile women under intrauterine insemination who referred to Mahdiyeh infertility clinic during 2008-2009. 106 infertile women were randomly divided into two equal groups. Patients were treated with 5 mg of letrozole daily (in letrozole group) or 100 mg of clomiphene citrate daily (in clomiphene group) for five days starting on day 3 of their menses. Dose and time of FSH was similar in the two groups. Number of follicles, endometrial thickness, Pregnancy rate and prevalence of complications were compared in the two groups. Mean (±SD) of age in letrozole and clomiphene groups was 26.3 ±3.9 and 25.2 ±4.9 respectively (P=0.186). Average number of follicles was 2.5 ± 1.65 in letrozole group and 2.36 ± 1.4 in clomiphene group (P=0.764). β-hCG was positive in 11 (20.8%) in letrozole and 12 (22.6%) in clomiphene groups (P=0.814). Pregnancy rate was 20.8% and 22.6% in letrozole and clomiphene group respectively (P=0.814). There was no difference in rate of abortion between groups. Endometrial thickness (ET) at the time of hCG administration in the letrozole (6.8 ±1.5 mm) and in clomiphene (6.6 ±1.2 mm) (P=0.615). But ET>7.4 mm was found in 2 cased (3.8%) in clomiphene group and 12 cases (%22.8) in letrozole groups (P=0.01). It appears that letrozole and clomiphene have similar outcome infertile women under intrauterine insemination and these drugs are good alternative for each others.

Borney R, Schus TD. Infertility. In: Berek JS, Novak E, editors. Berek and Novak's Gynecology. 14th ed. Philadelphia, Pa: Lippincott Williams and Wilkins: 2007:1185-277.

Sh Tehrani Nejad E, Abediasl Z, Rashidi BH, Azimi Nekoo E, Shariat M, Amirchaghmaghi E. Comparison of the efficacy of the aromatase inhibitor letrozole and clomiphen citrate gonadotropins in controlled ovarian hyperstimulation: a prospective, simply randomized, clinical trial. J Assist Reprod Genet 2008;25(5):187-90.

Balasch J. Gonadotrophin ovarian stimulation and intrauterine insemination for unexplained infertility. Reprod Biomed Online 2004;9(6):664-72.

Mitwally MF, Casper RF. Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate. Fertil Steril 2001;75(2):305-9.

Mitwally MF, Casper RF. Aromatase inhibition improves ovarian response to follicle-stimulating hormone in poor responders. Fertil Steril 2002;77(4):776-80.

Mitwally MF, Casper RF. Aromatase inhibition for ovarian stimulation: future avenues for infertility management. Curr Opin Obstet Gynecol 2002;14(3):255-63.

Speroff L, Fritz M. Induction of ovulation. In: Speroff L, Fritz MA, editors. Clinical Gynecologic Endocrinologyand Infertility. 7th ed. Philadelphia, Pa: LippincottWilliams and Wilkins: 2005. p. 1175-215.

Al-Fozan H, Al-Khadouri M, Tan SL, Tulandi T. A randomized trial of letrozole versus clomiphene citrate in women undergoing superovulation. Fertil Steril 2004;82(6):1561-3.

Jee BC, Ku SY, Suh CS, Kim KC, Lee WD, Kim SH. Use of letrozole versus clomiphene citrate combined withgonadotropins in intrauterine insemination cycles: a pilot study. Fertil Steril 2006;85(6):1774-7.

Begum MR, Ferdous J, Begum A, Quadir E. Comparison of efficacy of aromatase inhibitor and clomiphene citratein induction of ovulation in polycystic ovarian syndrome. Fertil Steril 2009;92(3):853-7.

Cortínez A, De Carvalho I, Vantman D, Gabler F, Iñiguez G, Vega M. Hormonal profile and endometrial morphology in letrozole-controlled ovarian hyperstimulation in ovulatory infertile patients. Fertil Steril 2005;83(1):110-5.

Ghazizadeh Sh, Amooei M, Bagheri M, Ghelichkhani M, Masoomi M. Comparing the effects of Clomiphene- HMG and Letrozole-HMG on ovulation induction in infertile women. J Reprod Infertil 2009;10(2):109-14.

Mitwally MF, Biljan MM, Casper RF. Pregnancy outcome after the use of an aromatase inhibitor for ovarian stimulation. Am J Obstet Gynecol= 2005;192(2):381-6.

Badawy A, Abdel Aal I, Abulatta M. Clomiphene citrate or letrozole for ovulation induction in women with polycystic ovarian syndrome: a prospective randomized trial. Fertil Steril 2009;92(3):849-52.

Barroso G, Menocal G, Felix H, Rojas-Ruiz JC, Arslan M, Oehninger S. Comparison of the efficacy of the aromatase inhibitor letrozole and clomiphene citrate as adjuvants to recombinant follicle-stimulating hormone in controlled ovarian hyperstimulation: a prospective, randomized, blinded clinical trial. Fertil Steril 2006;86(5):1428-31.

Fisher SA, Reid RL, Van Vugt DA, Casper RF. A randomized double-blind comparison of the effects of clomiphene citrate and the aromatase inhibitor letrozole on ovulatory function in normal women. Fertil Steril 2002;78(2):280-5.

Mitwally MF, Casper RF. Use of an aromatase inhibitor for induction of ovulation in patients with an inadequatemresponse to clomiphene citrate. Fertil Steril 2001;75(2):305-9.

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IssueVol 50, No 1 (2012) QRcode
SectionArticles
Keywords
Letrozole Clomiphene citrate Infertility Gonadotropin

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How to Cite
1.
Zadehmodares S, Niyakan M, Sharafy SA, Hosseinnezhad Yazdi M, Jahed F. Comparison of Treatment Outcomes of Infertile Women by Clomiphene Citrate and Letrozole with Gonadotropins Underwent Intrauterine Insemination. Acta Med Iran. 1;50(1):18-20.