Effects of letrozole alone or in combination with gonadotropins on ovulation induction and clinical pregnancy in women with polycystic ovarian syndrome: a systematic review and meta-analysis of randomized controlled trials.

Autor: Baradwan S; Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia., Al-Shalhoub F; Department of Obstetrics and Gynecology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia., Alshahrani MS; Department of Obstetrics and Gynecology, Faculty of Medicine, Najran University, Najran, Saudi Arabia., Himayda S; Department of Obstetrics and Gynecology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia., AlSghan R; Department of Obstetrics and Gynecology, Maternity and Children Hospital, Al-Kharj, Saudi Arabia., Sabban H; Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.; Department of Obstetrics and Gynecology, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia., Ahmad IH; Department of Endocrinology and Metabolism, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt., Sayed MFME; Department of Endocrinology and Metabolism, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt., Mohamad EO; Department of Endocrinology and Metabolism, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt., AlAmodi AA; College of Health Sciences and Public Health, Jackson State University, Jackson, MS, USA., Abdelhakim AM; Kasralainy Faculty of Medicine, Cairo University, 395 Portsaid Street, Bab El-Kalq, Cairo, 11638, Egypt. ahmed.m.rohei@students.kasralainy.edu.eg., Shaheen K; Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt.
Jazyk: angličtina
Zdroj: Hormones (Athens, Greece) [Hormones (Athens)] 2024 Sep; Vol. 23 (3), pp. 497-508. Date of Electronic Publication: 2024 Jan 27.
DOI: 10.1007/s42000-024-00531-4
Abstrakt: Objective: To compare letrozole in combination with gonadotropins versus letrozole monotherapy in ovulation induction and clinical pregnancy among infertile women with polycystic ovarian syndrome (PCOS).
Methods: Several databases were searched for available clinical trials from inception until March 2023. We selected randomized controlled trials (RCTs) that compared sequential letrozole/gonadotropin versus letrozole alone among infertile women who met the Rotterdam criteria for PCOS. RevMan software was used to perform our meta-analysis. Our primary outcomes were ovulation and clinical pregnancy rates. Our secondary outcomes were endometrial thickness, number of mature follicles (diameter ≥ 18 mm), and incidence of miscarriage and ovarian hyperstimulation syndrome (OHSS).
Results: Six RCTs were retrieved with a total number of 723 patients. The ovulation and clinical pregnancy rates were significantly higher among the letrozole/gonadotropin group versus the letrozole monotherapy group (p < 0.001). In addition, there were significant improvements in endometrial thickness and number of mature follicles in the letrozole/gonadotropin group. There were no significant differences between the two groups regarding incidence of miscarriage and ovarian hyperstimulation syndrome.
Conclusion: Letrozole in combination with gonadotropin is superior to letrozole alone in improving ovulation induction and clinical pregnancy among PCOS patients. More trials are required to confirm our findings.
(© 2024. The Author(s), under exclusive licence to Hellenic Endocrine Society.)
Databáze: MEDLINE
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