title: Congenital malformations among babies born following letrozole or clomiphene for infertility treatment.
abstract: BACKGROUND
  Clomiphene citrate (CC) is the first line drug for ovulation induction but because of its peripheral antiestrogenic effect, letrozole was introduced as the 2nd line drug. It lacks the peripheral antiestrogenic effect and is associated with similar or even higher pregnancy rates. Since letrozole is a drug for breast cancer, its use for the purpose of ovulation induction became controversial in the light of studies indicating an increased incidence of congenital malformations.
  
  
  OBJECTIVE
  To evaluate and compare the incidence of congenital malformations among offsprings of infertile couples who conceived naturally or with clomiphene citrate or letrozole treatment.
  
  
  METHODS
  A retrospective cohort study done at a tertiary infertility centre.
  
  
  METHODS
  A total of 623 children born to infertile women who conceived naturally or following clomiphene citrate or letrozole treatment were included in this study. Subjects were sorted out from medical files of both mother and newborn and follow up study was done based on the information provided by parents through telephonic conversations. Babies with suspected anomaly were called and examined by specialists for the presence of major and minor congenital malformations. Other outcomes like multiple pregnancy rate and birth weight were also studied.
  
  
  RESULTS
  Overall, congenital malformations, chromosomal abnormalities were found in 5 out of 171 (2.9%) babies in natural conception group and 5 out of 201 babies in the letrozole group (2.5%) and in 10 of 251 babies in the CC group (3.9%).
  
  
  CONCLUSIONS
  There was no significant difference in the overall rate of congenital malformations among children born to mothers who conceived naturally or after letrozole or CC treatment.
  
  
  CONCLUSIONS
  Congenital malformations have been found to be comparable following natural conception, letrozole and clomiphene citrate. Thus, the undue fear against letrozole may be uncalled for.
authors.affiliation: Institute of Reprooductive Medicine, Kolkata, West Bengal, India.
authors.forename: Sunita
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Institute of Reprooductive Medicine, Kolkata, West Bengal, India.
authors.forename: Sanghamitra
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: Institute of Reprooductive Medicine, Kolkata, West Bengal, India.
authors.forename: Soma
authors.initials: S
authors.lastname: Singh
authors.affiliation: Institute of Reprooductive Medicine, Kolkata, West Bengal, India.
authors.forename: Astha
authors.initials: A
authors.lastname: Chakravarty
authors.affiliation: School of Medical Science and Technology, Indian Institute of Technology, Kharagpur, India.
authors.forename: Ashalatha
authors.initials: A
authors.lastname: Ganesh
authors.affiliation: Institute of Reprooductive Medicine, Kolkata, West Bengal, India.
authors.forename: Shweta
authors.initials: S
authors.lastname: Rajani
authors.affiliation: Institute of Reprooductive Medicine, Kolkata, West Bengal, India.
authors.forename: B N
authors.initials: BN
authors.lastname: Chakravarty
mesh_terms: D001724:Birth Weight; D002648:Child; D002675:Child, Preschool; D002996:Clomiphene / Q000009:adverse effects* / Q000627:therapeutic use; D000013:Congenital Abnormalities / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D005300:Fertility Agents, Female / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007247:Infertility, Female / Q000188:drug therapy; D000077289:Letrozole; D008297:Male; D009570:Nitriles / Q000009:adverse effects* / Q000627:therapeutic use; D011247:Pregnancy; D012189:Retrospective Studies; D014230:Triazoles / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D005300:Fertility Agents, Female; D009570:Nitriles; D014230:Triazoles; D002996:Clomiphene; D000077289:Letrozole