title: Randomized controlled trial of letrozole, berberine, or a combination for infertility in the polycystic ovary syndrome.
abstract: OBJECTIVE
  To study whether a combination of berberine and letrozole results in higher live births than letrozole alone in infertile women with polycystic ovary syndrome (PCOS).
  
  
  METHODS
  A multicenter randomized double-blinded placebo-controlled trial.
  
  
  METHODS
  Reproductive and developmental network sites.
  
  
  METHODS
  Eligible women had PCOS as defined by the Rotterdam criteria. We enrolled 644 participants randomized 1:1:1 among letrozole, berberine, and combination groups.
  
  
  METHODS
  Berberine or berberine placebo were administrated orally at a daily dose of 1.5 g for up to 6 months. Patients received an initial dose of 2.5 mg letrozole or placebo on days 3-7 of the first three treatment cycles. This dose was increased to 5 mg on the last three cycles if not pregnant.
  
  
  METHODS
  Cumulative live births.
  
  
  RESULTS
  The cumulative live births were similar between the letrozole and combination groups after treatment (36% and 34%), and were superior to those in the berberine group (22%). Likely, conception, pregnancy, and ovulation rates were similar between the letrozole and combination groups, and these were significantly higher than in the berberine group. There was one twin birth in the letrozole group, three twin births in the combination group, and none in the berberine group.
  
  
  CONCLUSIONS
  Berberine did not add fecundity in PCOS when used in combination with the new ovulation agent letrozole.
  
  
  BACKGROUND
  ChiCTR-TRC-09000376 (http://apps.who.int/trialsearch/).
authors.affiliation: Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, People's Republic of China; Institute of Basic Clinical Medicine, China Academy of Chinese Medical Science, Beijing, People's Republic of China. Electronic address: xiaokewu2002@vip.sina.com.
authors.forename: Xiao-Ke
authors.initials: XK
authors.lastname: Wu
authors.affiliation: Institute of Basic Clinical Medicine, China Academy of Chinese Medical Science, Beijing, People's Republic of China.
authors.forename: Yong-Yan
authors.initials: YY
authors.lastname: Wang
authors.affiliation: Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, People's Republic of China.
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Liu
authors.affiliation: Department of Gynecology, First Hospital, Jiangxi University of Chinese Medicine, Nanchang, People's Republic of China.
authors.forename: Rui-Ning
authors.initials: RN
authors.lastname: Liang
authors.affiliation: Center for Reproductive Medicine, Huaian Maternal and Child Health Hospital, Huaian, People's Republic of China.
authors.forename: Hui-Ying
authors.initials: HY
authors.lastname: Xue
authors.affiliation: Department of Chinese Medicine, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, People's Republic of China.
authors.forename: Hong-Xia
authors.initials: HX
authors.lastname: Ma
authors.affiliation: Center for Reproductive Medicine, Dalian Maternal and Children's Health Center, Dalian, People's Republic of China.
authors.forename: Xiao-Guang
authors.initials: XG
authors.lastname: Shao
authors.affiliation: Department of Obstetrics and Gynecology, University of Hong Kong, Hong Kong, People's Republic of China.
authors.forename: Ernest H Y
authors.initials: EH
authors.lastname: Ng
mesh_terms: D000284:Administration, Oral; D000328:Adult; D001599:Berberine / Q000008:administration & dosage* / Q000009:adverse effects; D002681:China; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005298:Fertility / Q000187:drug effects*; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D000077289:Letrozole; D050498:Live Birth; D009570:Nitriles / Q000008:administration & dosage* / Q000009:adverse effects; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D011247:Pregnancy; D018873:Pregnancy Rate; D013997:Time Factors; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D005300:Fertility Agents, Female; D009570:Nitriles; D014230:Triazoles; D001599:Berberine; D000077289:Letrozole
keywords: PCOS; RCT; berberine; infertility; letrozole; live birth