The aromatase inhibitor letrozole increases the concentration of intraovarian androgens and improves in vitro fertilization outcome in low responder patients: a pilot study.
OBJECTIVE
To evaluate the impact of aromatase inhibitors as adjuvant treatment in IVF cycles on intraovarian androgens and cycle outcome.


METHODS
Observational, pilot study.


METHODS
University-affiliated IVF unit.


METHODS
One hundred forty-seven low responder patients with a previous canceled IVF cycle; 71 patients were treated with letrozole 2.5 mg plus a high-dose FSH/hMG-antagonist regimen, and 76 patients were similarly treated but letrozole was not employed.


METHODS
In vitro fertilization treatment with an antagonist FSH/hMG protocol with or without letrozole was administered during the first 5 days of stimulation; hormones were evaluated in both serum and follicular fluid.


METHODS
Number of oocytes retrieved, fertilization rate, implantation rate, and pregnancy rate; androstenedione, T, E2, and P values in serum and follicular fluid.


RESULTS
Letrozole-treated patients showed significantly higher levels of follicular fluid T and androstenedione (80.3 vs. 43.8 pg/mL and 57.9 vs. 37.4 mg/mL, respectively). Similarly, these patients had a higher number of oocytes retrieved (6.1 vs. 4.3) and a higher implantation rate (25% vs. 9.4%) despite similar doses of FSH/hMG (3,627 vs. 3,804 IU).


CONCLUSIONS
Adding 2.5 mg of letrozole to a high-dose FSH/hMG antagonist protocol increases intraovarian androstenedione and T concentration and improves IVF cycle outcome in poor responder patients.
Garcia-Velasco
Juan A
JA
IVI-Madrid, Rey Juan Carlos University, Madrid, Spain. jgvelasco@ivi.es
Moreno
Luis
L
Pacheco
Alberto
A
Guillén
Alfredo
A
Duque
Luis
L
Requena
Antonio
A
Pellicer
Antonio
A
D000328:Adult; D000728:Androgens / Q000378:metabolism*; D047072:Aromatase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D016009:Chi-Square Distribution; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D000077289:Letrozole; D009570:Nitriles / Q000494:pharmacology* / Q000627:therapeutic use; D010053:Ovary / Q000187:drug effects* / Q000378:metabolism*; D010062:Ovulation Induction / Q000379:methods; D010865:Pilot Projects; D011247:Pregnancy; D011446:Prospective Studies; D014230:Triazoles / Q000494:pharmacology* / Q000627:therapeutic use
D000728:Androgens; D047072:Aromatase Inhibitors; D009570:Nitriles; D014230:Triazoles; D000077289:Letrozole