Efficacy of letrozole and clomiphene in patients with multiple-cause infertility undergoing intrauterine insemination

M. W. Lee, Kumolosasi Msi Endang, Zainul Rashid Mohd. Razi, Mohd Makmor Bakry, Suria Abdul Aziz

Research output: Contribution to journalArticle

Abstract

What is known: Clomiphene is commonly used in infertility treatment prior to intrauterine insemination (IUI). In treatment failure, exogenous gonadotropins are used as a second-line treatment, but are associated with a higher risk of ovarian hyperstimulation syndrome and multiple gestations. Letrozole has been introduced as a new oral treatment option. Objectives: This study evaluated the efficacy of these two drugs in infertile patients who underwent IUI. Methods: A total of 127 patients who received either letrozole (2.5 -7.5 mg daily) or clomiphene (50-200 mg daily) and underwent IUI at the medical centre between 1 January 2004 and 31 January 2011 were included in this retrospective study. Parameters measured were the endometrium thickness, follicle size, number of follicles > 18 mm, ovulation, pregnancy, miscarriage and full term pregnancy rates as well as adverse events. Results: The rate of endometrium growth was higher in the letrozole group (0.95 ± 0.66 mm/day vs. 0.48 ± 0.70 mm/day, p=0.029) and the endometrium thickness on day 12 and day 13 of cycle was also higher in the letrozole group (10.094 0 ± 1.69 mm vs. 8.973 ± 1.70, p=0.025). Although the number of dominant follicles was lower (1.33 ± 0.50 vs. 2.32 ± 1.11, p=0.001), ovulation rates was higher in the letrozole group (97.83% vs. 85.12%, p=0.05). The pregnancy rates were similar in the letrozole and clomiphene group (4.35% vs. 3.70%, p = 0.768), but the miscarriage rates were higher in the clomiphene group. What is new: The study included Malaysian patients with multiple-causes infertility. Conclusion: Letrozole is shown to produce higher rate of endometrium growth, thicker endometrium and produce higher ovulation relative to clomiphene. Although pregnancy rates were similar in both groups, clomiphene may be associated with risks of miscarriages.

Original languageEnglish
Pages (from-to)264-269
Number of pages6
JournalInternational Journal of Pharmacy and Pharmaceutical Sciences
Volume4
Issue numberSUPPL.3
Publication statusPublished - 2012

Fingerprint

letrozole
Clomiphene
Insemination
Infertility
Endometrium
Spontaneous Abortion
Pregnancy Rate
Ovulation
Ovarian Hyperstimulation Syndrome
Pregnancy
Growth
Treatment Failure
Gonadotropins

Keywords

  • Clomiphene
  • Endometrium thickness
  • Follicular development
  • Infertility
  • Intrauterine insemination (IUI)
  • Letrozole

ASJC Scopus subject areas

  • Pharmaceutical Science
  • Pharmacology

Cite this

@article{e8054aa9d31c43518bdf8c8d7ce9a46b,
title = "Efficacy of letrozole and clomiphene in patients with multiple-cause infertility undergoing intrauterine insemination",
abstract = "What is known: Clomiphene is commonly used in infertility treatment prior to intrauterine insemination (IUI). In treatment failure, exogenous gonadotropins are used as a second-line treatment, but are associated with a higher risk of ovarian hyperstimulation syndrome and multiple gestations. Letrozole has been introduced as a new oral treatment option. Objectives: This study evaluated the efficacy of these two drugs in infertile patients who underwent IUI. Methods: A total of 127 patients who received either letrozole (2.5 -7.5 mg daily) or clomiphene (50-200 mg daily) and underwent IUI at the medical centre between 1 January 2004 and 31 January 2011 were included in this retrospective study. Parameters measured were the endometrium thickness, follicle size, number of follicles > 18 mm, ovulation, pregnancy, miscarriage and full term pregnancy rates as well as adverse events. Results: The rate of endometrium growth was higher in the letrozole group (0.95 ± 0.66 mm/day vs. 0.48 ± 0.70 mm/day, p=0.029) and the endometrium thickness on day 12 and day 13 of cycle was also higher in the letrozole group (10.094 0 ± 1.69 mm vs. 8.973 ± 1.70, p=0.025). Although the number of dominant follicles was lower (1.33 ± 0.50 vs. 2.32 ± 1.11, p=0.001), ovulation rates was higher in the letrozole group (97.83{\%} vs. 85.12{\%}, p=0.05). The pregnancy rates were similar in the letrozole and clomiphene group (4.35{\%} vs. 3.70{\%}, p = 0.768), but the miscarriage rates were higher in the clomiphene group. What is new: The study included Malaysian patients with multiple-causes infertility. Conclusion: Letrozole is shown to produce higher rate of endometrium growth, thicker endometrium and produce higher ovulation relative to clomiphene. Although pregnancy rates were similar in both groups, clomiphene may be associated with risks of miscarriages.",
keywords = "Clomiphene, Endometrium thickness, Follicular development, Infertility, Intrauterine insemination (IUI), Letrozole",
author = "Lee, {M. W.} and Endang, {Kumolosasi Msi} and {Mohd. Razi}, {Zainul Rashid} and {Makmor Bakry}, Mohd and {Abdul Aziz}, Suria",
year = "2012",
language = "English",
volume = "4",
pages = "264--269",
journal = "International Journal of Pharmacy and Pharmaceutical Sciences",
issn = "0975-1491",
publisher = "IJPPS",
number = "SUPPL.3",

}

TY - JOUR

T1 - Efficacy of letrozole and clomiphene in patients with multiple-cause infertility undergoing intrauterine insemination

AU - Lee, M. W.

AU - Endang, Kumolosasi Msi

AU - Mohd. Razi, Zainul Rashid

AU - Makmor Bakry, Mohd

AU - Abdul Aziz, Suria

PY - 2012

Y1 - 2012

N2 - What is known: Clomiphene is commonly used in infertility treatment prior to intrauterine insemination (IUI). In treatment failure, exogenous gonadotropins are used as a second-line treatment, but are associated with a higher risk of ovarian hyperstimulation syndrome and multiple gestations. Letrozole has been introduced as a new oral treatment option. Objectives: This study evaluated the efficacy of these two drugs in infertile patients who underwent IUI. Methods: A total of 127 patients who received either letrozole (2.5 -7.5 mg daily) or clomiphene (50-200 mg daily) and underwent IUI at the medical centre between 1 January 2004 and 31 January 2011 were included in this retrospective study. Parameters measured were the endometrium thickness, follicle size, number of follicles > 18 mm, ovulation, pregnancy, miscarriage and full term pregnancy rates as well as adverse events. Results: The rate of endometrium growth was higher in the letrozole group (0.95 ± 0.66 mm/day vs. 0.48 ± 0.70 mm/day, p=0.029) and the endometrium thickness on day 12 and day 13 of cycle was also higher in the letrozole group (10.094 0 ± 1.69 mm vs. 8.973 ± 1.70, p=0.025). Although the number of dominant follicles was lower (1.33 ± 0.50 vs. 2.32 ± 1.11, p=0.001), ovulation rates was higher in the letrozole group (97.83% vs. 85.12%, p=0.05). The pregnancy rates were similar in the letrozole and clomiphene group (4.35% vs. 3.70%, p = 0.768), but the miscarriage rates were higher in the clomiphene group. What is new: The study included Malaysian patients with multiple-causes infertility. Conclusion: Letrozole is shown to produce higher rate of endometrium growth, thicker endometrium and produce higher ovulation relative to clomiphene. Although pregnancy rates were similar in both groups, clomiphene may be associated with risks of miscarriages.

AB - What is known: Clomiphene is commonly used in infertility treatment prior to intrauterine insemination (IUI). In treatment failure, exogenous gonadotropins are used as a second-line treatment, but are associated with a higher risk of ovarian hyperstimulation syndrome and multiple gestations. Letrozole has been introduced as a new oral treatment option. Objectives: This study evaluated the efficacy of these two drugs in infertile patients who underwent IUI. Methods: A total of 127 patients who received either letrozole (2.5 -7.5 mg daily) or clomiphene (50-200 mg daily) and underwent IUI at the medical centre between 1 January 2004 and 31 January 2011 were included in this retrospective study. Parameters measured were the endometrium thickness, follicle size, number of follicles > 18 mm, ovulation, pregnancy, miscarriage and full term pregnancy rates as well as adverse events. Results: The rate of endometrium growth was higher in the letrozole group (0.95 ± 0.66 mm/day vs. 0.48 ± 0.70 mm/day, p=0.029) and the endometrium thickness on day 12 and day 13 of cycle was also higher in the letrozole group (10.094 0 ± 1.69 mm vs. 8.973 ± 1.70, p=0.025). Although the number of dominant follicles was lower (1.33 ± 0.50 vs. 2.32 ± 1.11, p=0.001), ovulation rates was higher in the letrozole group (97.83% vs. 85.12%, p=0.05). The pregnancy rates were similar in the letrozole and clomiphene group (4.35% vs. 3.70%, p = 0.768), but the miscarriage rates were higher in the clomiphene group. What is new: The study included Malaysian patients with multiple-causes infertility. Conclusion: Letrozole is shown to produce higher rate of endometrium growth, thicker endometrium and produce higher ovulation relative to clomiphene. Although pregnancy rates were similar in both groups, clomiphene may be associated with risks of miscarriages.

KW - Clomiphene

KW - Endometrium thickness

KW - Follicular development

KW - Infertility

KW - Intrauterine insemination (IUI)

KW - Letrozole

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