Does the additional use of clomiphene citrate or letrozole for in vitro fertilization deserve more attention?
Autor: | Zheng-Li Feng, Ying Liang, Qing Guo, Jun Ge, Li-Nan Zhang, Xiao-Qian Wu, Xiao-Hua Wu, Mei-Ling Xu |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Infertility
Adult medicine.medical_specialty Pregnancy Rate medicine.medical_treatment Ovarian hyperstimulation syndrome Administration Oral Gastroenterology Injections Intramuscular lcsh:Gynecology and obstetrics Clomiphene 03 medical and health sciences Ovarian Hyperstimulation Syndrome Young Adult Clomiphene Citrate 0302 clinical medicine Internal medicine medicine Humans lcsh:RG1-991 Pregnancy 030219 obstetrics & reproductive medicine In vitro fertilisation Dose-Response Relationship Drug business.industry Letrozole Incidence Obstetrics and Gynecology medicine.disease Antral follicle Embryo Transfer Pregnancy rate Treatment Outcome 030220 oncology & carcinogenesis Feasibility Studies Ovulation induction Female ovulation induction pregnancy business infertility Gonadotropins medicine.drug Research Article |
Zdroj: | BMC Pregnancy and Childbirth, Vol 21, Iss 1, Pp 1-8 (2021) BMC Pregnancy and Childbirth |
ISSN: | 1471-2393 |
Popis: | Background Adding clomiphene citrate (CC) and/or letrozole (LE) to in vitro fertilization (IVF) cycles for mild ovarian stimulation is a general approach. Although lots of researches have demonstrated partial benefits of the strategy, all-around effects of oral medications remained deficient. This paper aims to assess whether an addition of oral medication will result in considerable outcomes on T-Gn (total dose of gonadotropin), Gn days, total retrieved ova, high quality embryos, blastocyst number, ovarian hyperstimulation syndrome (OHSS) rate, clinical pregnancy rate and cumulative pregnancy rate, even if it was not conventional mild/minimal stimulations. Results Participants were categorized to three diverse populations as high responders, normal responders and poor responders according to basal antral follicle count. T-Gn in patients treated with CC/LE distinctly decreased from 2496.96 IU/d to 1827.68 IU/d, from 2860.28 IU/d to 2119.99 IU/d, and from 3182.15 IU/d to 1802.84 IU/d, respectively. For high ovary responders and normal responders, the OHSS incidence rate also declined from 29.2 to 4.3% (P P = 0.090). Other, there was no statistical difference with respect to the T-retrieved ova (total retrieved ova), high quality embryos, cultured blastocyst and blastocyst number in high responders. For normal responders and poor ovary responders, T-Gn, Gn days, T-retrieved ova, high quality embryos, cultured blastocyst and blastocysts number in oral medications group all apparently decreased. Clinical pregnancy rate per fresh cycle of poor responders with prior oral medications was significantly decreased (25.7% vs. 50.8%, P = 0.005), and no significant differences in high responders and normal responders were expressed (52.5% vs. 44.2%, P = 0.310; 51.9% vs. 42.4%, P = 0.163) between two groups of participants. The numbers of cumulative pregnancy rates were lower in the conventional group compared to the add group for high (75.90% versus 81.03%, P = 0.279), normal (62.69% versus 71.36%, P = 0.016) and poor (39.74% versus 68.21%, P Conclusions The addition of CC/LE to the ovulation induction during IVF has certain efficacy in terms of low cost, low OHSS incidence. CC/LE deserves more recommendations as a responsible strategy in high responders due to advantageous pregnancy outcomes. For normal responders, the strategy needs to be considered with more comprehensive factors. |
Databáze: | OpenAIRE |
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