Effect of letrozole at 2.5 mg or 5.0 mg/day on ovarian stimulation with gonadotropins in women undergoing intrauterine insemination.
OBJECTIVE
To determine the effect of combined therapy of letrozole (2.5 mg or 5.0 mg) with recombinant follicle-stimulating hormone (FSH) in comparison with the administration of recombinant FSH alone in an intrauterine insemination (IUI) program.


METHODS
Retrospective study.


METHODS
Assisted fertilization program in a specialized infertility center.


METHODS
110 women undergoing IUI and gonadotropin therapy.


METHODS
Recombinant FSH alone administered from day 3 or combined with letrozole, 2.5 or 5.0 mg/day, on days 3 to 7, and gonadotropins starting on day 7 of the menstrual cycle. Transvaginal ultrasound examinations were done until the dominant follicle reached 18 mm in diameter. Ovulation was triggered with 10,000 IU of human chorionic gonadotropin (hCG), and IUI performed 30 to 40 hours later.


METHODS
Recombinant FSH dose required, number of follicles greater than 14 mm and 18 mm, endometrial thickness, pregnancy rates, miscarriages, and characteristics of newborns.


RESULTS
Women treated with FSH and 5.0 mg/day of letrozole required a lower dose of FSH than the group cotreated with 2.5 mg/day of letrozole or with FSH alone. Throughout most of the follicular phase, the endometrial thickness was statistically significantly less in both letrozole cotreatment groups compared with the FSH control group. By the day of hCG administration, the endometrial thickness was comparable among all the groups. The pregnancy rates were the same with recombinant FSH alone or combined with letrozole.


CONCLUSIONS
In terms of cost-effectiveness, 5.0 mg/day of letrozole is more effective than the 2.5 mg/day in cotreatment with no adverse effect on pregnancy rate or outcome.
Noriega-Portella
Luis
L
PRANOR, Group of Assisted Reproduction, Universidad Peruana Cayetano Heredia, Lima, Peru.
Noriega-Hoces
Luis
L
Delgado
Andrea
A
Rubio
Julio
J
Gonzales-Castañeda
Cynthia
C
Gonzales
Gustavo F
GF
D000022:Abortion, Spontaneous / Q000209:etiology; D000328:Adult; D047072:Aromatase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D003362:Cost-Benefit Analysis; D004334:Drug Administration Schedule; D016527:Drug Costs; D004359:Drug Therapy, Combination; D004717:Endometrium / Q000000981:diagnostic imaging / Q000187:drug effects; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D006801:Humans; D007246:Infertility / Q000628:therapy*; D007315:Insemination, Artificial / Q000191:economics; D000077289:Letrozole; D050498:Live Birth; D009570:Nitriles / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D010060:Ovulation / Q000187:drug effects*; D010062:Ovulation Induction / Q000191:economics; D011247:Pregnancy; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple; D011994:Recombinant Proteins / Q000008:administration & dosage; D012189:Retrospective Studies; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D014463:Ultrasonography
D047072:Aromatase Inhibitors; D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D009570:Nitriles; D011994:Recombinant Proteins; D014230:Triazoles; D000077289:Letrozole; D005640:Follicle Stimulating Hormone