title: A retrospective analysis of ovarian stimulation with letrozole in women undergoing artificial insemination by donor.
abstract: The aim of this retrospective study was to determine the clinical pregnancy rate in women undergoing letrozole ovarian stimulation and artificial insemination by donor (AID). Between 2012 and 2015, 130 natural cycles, 939 letrozole cycles and 130 letrozole plus gonadotrophin cycles were conducted. Letrozole cycles were divided into three groups according to LH concentration on the day of HCG administration (LH <10 mIU/ml and follicle size ≥18 cm; LH ≤10 to <20 mIU/ml; and LH ≥20 mIU/ml). Pregnancy rates were 17.3%, 22.4% and 26.8%, respectively (P = 0.012). In women given 10 mIU/ml LH or more, logistic regression identified oestradiol (OR 1.002, 95% CI, 1.000 to 1.004, P = 0.029) and leading follicle size (OR 0.861, 95% CI, 0.772 to 0.960, P = 0.007) as significant predictive factors of pregnancy rate; the higher the oestradiol and the smaller the follicles, the better the pregnancy rate. The pregnancy rate was significantly higher in the letrozole plus gonadotrophin group than the letrozole group (P = 0.04). Better pregnancy rates can be achieved if LH surge occurs before HCG administration, especially with higher oestradiol and lower follicle size; treatment with letrozole plus gonadotrophin was significantly more effective than letrozole alone in AID.
authors.affiliation: Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: X J
authors.initials: XJ
authors.lastname: Sun
authors.affiliation: Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: L
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: L C
authors.initials: LC
authors.lastname: Ji
authors.affiliation: Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: R
authors.initials: R
authors.lastname: Nie
authors.affiliation: Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
authors.forename: H
authors.initials: H
authors.lastname: Chen
authors.affiliation: Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: Ljin@tjh.tjmu.edu.cn.
authors.forename: L
authors.initials: L
authors.lastname: Jin
authors.affiliation: Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: zhu_guijin@sina.com.
authors.forename: G J
authors.initials: GJ
authors.lastname: Zhu
authors.affiliation: Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: qiankun1129@sina.com.
authors.forename: K
authors.initials: K
authors.lastname: Qian
mesh_terms: D047072:Aromatase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004958:Estradiol / Q000097:blood; D005260:Female; D006062:Gonadotropins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007316:Insemination, Artificial, Heterologous; D000077289:Letrozole; D016015:Logistic Models; D009570:Nitriles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006080:Ovarian Follicle / Q000000981:diagnostic imaging; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D014230:Triazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D047072:Aromatase Inhibitors; D006062:Gonadotropins; D009570:Nitriles; D014230:Triazoles; D004958:Estradiol; D000077289:Letrozole
keywords: Letrozole; estradiol; follicle size; luteinizing hormone monitoring; ovarian stimulation; pregnancy