The Efficacy of Letrozole Co-Treatment in an Antagonist Protocol for Women with Polycystic Ovary Syndrome Undergoing IVF: A Retrospective Study

IF 4.7 2区医学 Q1 CHEMISTRY, MEDICINAL Drug Design, Development and Therapy Pub Date : 2024-07-08 DOI:10.2147/dddt.s458608

Jing Lin, Fenglu Wu, Yanwen Zhu, Qianqian Zhu, Tong Du, Jiaying Lin

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Abstract

Objective: Our objective was to investigate the efficacy of letrozole co-treatment in an antagonist protocol for infertile women with polycystic ovary syndrome (PCOS).
Patients and Methods: This retrospective cohort study included infertile women with PCOS undergoing IVF/ICSI with and without letrozole co-treatment in an antagonist protocol from 2007– 2021 at Shanghai Ninth People’s Hospital (Shanghai, China). A total of 1559 participants were enrolled, with 1227 women in the antagonist group and 332 women in the letrozole co-treatment group. Propensity score-based patient-matching model was conducted to balance covariates between the groups. The primary outcome was the number of retrieved oocytes, with secondary outcomes including endocrine parameters, ovarian stimulation outcomes, pregnancy outcomes, and obstetrical and neonatal complications.
Results: Letrozole co-treatment induced significant changes in hormonal regulation, increased the percentage of large follicles, and resulted in fewer retrieved oocytes (P < 0.05). However, there was no negative impact on the number of usable embryos or good-quality embryos (P > 0.05). The live birth rates following fresh embryo transfer were comparable between the letrozole and control groups (single embryo transfer: 28.9% vs 29.7%, P > 0.05; double embryo transfer: 37.3% vs 45.6%, P > 0.05). Additionally, there were no significant differences between the two groups in the live birth rate per patient after frozen embryo transfer and the cumulative live birth rate (P > 0.05). No significant differences in obstetrical and neonatal complications were observed between the groups (P > 0.05).
Conclusion: The addition of letrozole to the antagonist protocol for women with PCOS undergoing IVF induces a higher percentage of large follicles during oocyte retrieval, while reducing the overall number of retrieved oocytes. Moreover, the use of letrozole demonstrates comparable clinical outcomes following embryo transfers. These findings highlight the potential application of letrozole in an antagonist protocol for women with PCOS.

Keywords: letrozole, antagonist protocol, polycystic ovary syndrome, follicle, in vitro fertilization

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多囊卵巢综合征妇女试管婴儿拮抗剂方案中来曲唑联合治疗的疗效：一项回顾性研究

目的：我们的目的是研究来曲唑联合治疗多囊卵巢综合征（PCOS）不孕妇女的疗效：我们的目的是研究来曲唑联合治疗对多囊卵巢综合征（PCOS）不孕妇女的疗效：这项回顾性队列研究纳入了2007年至2021年期间在上海市第九人民医院（中国上海）接受IVF/ICSI拮抗剂方案来曲唑联合治疗和未接受来曲唑联合治疗的多囊卵巢综合征不孕妇女。共有1559名患者参加了该研究，其中拮抗剂组1227名，来曲唑联合治疗组332名。研究采用基于倾向评分的患者匹配模型来平衡两组间的协变量。主要结果是取卵数量，次要结果包括内分泌参数、卵巢刺激结果、妊娠结果以及产科和新生儿并发症：结果：来曲唑联合治疗引起了激素调节的显著变化，增加了大卵泡的比例，并导致取卵数量减少（P < 0.05）。但是，对可用胚胎或优质胚胎的数量没有负面影响（P > 0.05）。来曲唑组和对照组在新鲜胚胎移植后的活产率相当（单胚胎移植：28.9% vs 29.7%，P > 0.05；双胚胎移植：37.3% vs 45.6%，P > 0.05）：37.3%对45.6%，P> 0.05）。此外，冷冻胚胎移植后每名患者的活产率和累计活产率在两组间无显著差异（P > 0.05）。两组患者的产科和新生儿并发症无明显差异（P> 0.05）：结论：对接受体外受精的多囊卵巢综合征妇女而言，在拮抗剂方案中加入来曲唑可在卵母细胞提取过程中诱导出更高比例的大卵泡，同时减少提取的卵母细胞总数。此外，来曲唑在胚胎移植后的临床效果也相当可观。这些发现凸显了来曲唑在多囊卵巢综合征妇女拮抗剂方案中的潜在应用。关键词：来曲唑；拮抗剂方案；多囊卵巢综合征；卵泡；体外受精

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来源期刊

Drug Design, Development and Therapy CHEMISTRY, MEDICINAL-PHARMACOLOGY & PHARMACY

CiteScore

9.00

自引率

0.00%

发文量

382

审稿时长

>12 weeks

期刊介绍： Drug Design, Development and Therapy is an international, peer-reviewed, open access journal that spans the spectrum of drug design, discovery and development through to clinical applications. The journal is characterized by the rapid reporting of high-quality original research, reviews, expert opinions, commentary and clinical studies in all therapeutic areas. Specific topics covered by the journal include: Drug target identification and validation Phenotypic screening and target deconvolution Biochemical analyses of drug targets and their pathways New methods or relevant applications in molecular/drug design and computer-aided drug discovery* Design, synthesis, and biological evaluation of novel biologically active compounds (including diagnostics or chemical probes) Structural or molecular biological studies elucidating molecular recognition processes Fragment-based drug discovery Pharmaceutical/red biotechnology Isolation, structural characterization, (bio)synthesis, bioengineering and pharmacological evaluation of natural products** Distribution, pharmacokinetics and metabolic transformations of drugs or biologically active compounds in drug development Drug delivery and formulation (design and characterization of dosage forms, release mechanisms and in vivo testing) Preclinical development studies Translational animal models Mechanisms of action and signalling pathways Toxicology Gene therapy, cell therapy and immunotherapy Personalized medicine and pharmacogenomics Clinical drug evaluation Patient safety and sustained use of medicines.