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
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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