Randomized controlled trial comparing superovulation with letrozole versus recombinant follicle-stimulating hormone combined with intrauterine insemination for couples with unexplained infertility who had failed clomiphene citrate stimulation and intrauterine insemination.
OBJECTIVE
To compare the efficacy of letrozole to recombinant FSH for ovarian stimulation combined with IUI in a group of patients that had failed to conceive after clomiphene citrate (CC) and IUI.


METHODS
Prospective randomized trial with human subjects.


METHODS
University-based fertility center.


METHODS
Fifty couples with unexplained infertility that failed to conceive after three cycles of CC combined to IUI.


METHODS
Couples were randomized to undergo superovulation either with letrozole or with recombinant FSH combined to IUI.


METHODS
Clinical pregnancy per cycle of treatment and clinical pregnancy per couple.


RESULTS
Pregnancy rate (PR) per cycle was 8.9% in the letrozole group as compared with 14% in the gonadotropin IUI group. This resulted in a cumulative PR per couple of 24% versus 36% and a take home baby rate of 20% versus 28%. Endometrial thickness was significantly lower in the letrozole group (7.1 +/- 2.3 vs 8.6 +/- 1.8).


CONCLUSIONS
Ovarian stimulation with letrozole is associated with acceptable PRs compared with gonadotropin with significant less cost, risks, and patient inconvenience.
Gregoriou
Odysseas
O
Aretaieion University Hospital, Athens, Greece.
Vlahos
Nikos F
NF
Konidaris
Socrates
S
Papadias
Konstantinos
K
Botsis
Dimitrios
D
Creatsas
George K
GK
D000328:Adult; D047072:Aromatase Inhibitors / Q000008:administration & dosage; D002996:Clomiphene / Q000008:administration & dosage*; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage* / Q000235:genetics; D006801:Humans; D007246:Infertility / Q000188:drug therapy*; D007315:Insemination, Artificial; D000077289:Letrozole; D009570:Nitriles / Q000008:administration & dosage*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011994:Recombinant Proteins / Q000008:administration & dosage; D017211:Treatment Failure; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage*
D047072:Aromatase Inhibitors; D005300:Fertility Agents, Female; D009570:Nitriles; D011994:Recombinant Proteins; D014230:Triazoles; D002996:Clomiphene; D000077289:Letrozole; D005640:Follicle Stimulating Hormone