Comparison of endocrine and ultrasound profiles during ovulation induction with clomiphene citrate and letrozole in ovulatory volunteer women.
OBJECTIVE
To compare endocrine and follicular dynamics in ovulatory volunteer women in natural cycles and cycles stimulated with clomiphene (CC) and letrozole (LE).


METHODS
Prospective, randomized, double-blind, crossover study.


METHODS
A private tertiary fertility center.


METHODS
Thirty ovulatory volunteer women (<39 years).


METHODS
Randomized ovarian stimulation with CC and LE compared with no treatment.


METHODS
Hormone profiles, follicular development, and endometrial development through the cycles.


RESULTS
The LE-treated cycles had the shortest follicular phase (13.1 vs. 13.9 days with CC) with less multiple follicular development than CC. They showed higher midfollicular LH concentrations (7.5 IU/L vs. 6.0 IU/L), lower LH surge values (27.9 IU/L vs. 44.4 IU/L), and lower E(2) concentrations than natural cycles. The LE cycles showed significant increases in free androgen index in the midfollicular phase compared with the CC cycles. Endometrial thickness in LE cycles (8.3 mm) was similar to natural cycles, whereas in CC cycles it was reduced (7.6 mm vs. 8.5 mm) compared with natural cycles. Ovulation profiles were similar in all cycles.


CONCLUSIONS
The LE treatment of normal women led to multiple follicular development, but less than CC. Estradiol concentrations were reduced, follicular phase length was shorter, whereas endometrial thickness and luteal P were normal. Follicular phase increased free androgen index is a novel finding and may explain the physiological observations.
Jirge
Padma Rekha
PR
Department of Reproductive Medicine, Sushrut, Assisted Conception and Endogynaecology Centre, Kolhapur, India. rekha.jirge@gmail.com
Patil
Rajendra S
RS
D000328:Adult; D015415:Biomarkers / Q000097:blood; D002996:Clomiphene / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004717:Endometrium / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism; D004958:Estradiol / Q000097:blood; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005498:Follicular Phase / Q000187:drug effects / Q000378:metabolism; D006728:Hormones / Q000097:blood*; D006801:Humans; D000077289:Letrozole; D007986:Luteinizing Hormone / Q000097:blood; D009570:Nitriles / Q000627:therapeutic use*; D018587:Oocyte Donation; D006080:Ovarian Follicle / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism; D010060:Ovulation / Q000187:drug effects*; D010062:Ovulation Induction / Q000379:methods*; D011446:Prospective Studies; D013739:Testosterone / Q000097:blood; D013997:Time Factors; D014230:Triazoles / Q000627:therapeutic use*; D014463:Ultrasonography; D055815:Young Adult
D015415:Biomarkers; D005300:Fertility Agents, Female; D006728:Hormones; D009570:Nitriles; D014230:Triazoles; D002996:Clomiphene; D013739:Testosterone; D004958:Estradiol; D000077289:Letrozole; D007986:Luteinizing Hormone