Comparing the effect of gonadotropin versus letrozole for induction of ovulation in patients with polycystic ovary syndrome with clomiphene citrate failure

Ahmed M Ali, A. E. Ahmed, A. Elboghdady
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Abstract

Background and aim Polycystic ovary syndrome (PCOS) is an endocrinopathy affecting women during the childbearing period, with incidences of between 8 and 13%. PCOS is the main cause of anovulatory infertility with a prevalence of 20% in infertile women. We aimed to compare the ovulation induction effect of letrozole versus gonadotropins in patients with PCOS after clomiphene citrate (CC) failure. Patients and methods This is a prospective comparative study held in the El Hussien University Hospital, Al-Azhar University; throughout the duration of 12 months from January 2020 to January 2021. In all, 100 women were enrolled in the study diagnosed with PCOS with an ovulatory infertility and after CC failure, patients were allocated into two groups in a ratio of 1 : 1. The first group included 50 patients and received (letrozole 2.5 mg tablet) twice daily. Results There was higher incidence of confirmed ovulation in the gonadotropin group (62%) compared with the letrozole group (58%) with no significance. It also showed a higher incidence of confirmed pregnancy in the gonadotropin group (34%) compared with the letrozole group (30%), but that difference was statistically nonsignificant. The results showed a shorter duration till the day of trigger in the letrozole group (13.48) compared with the gonadotropin group (14.55), the difference was significant. Endometrial thickness on day of trigger was higher in the gonadotropin group (11.3) compared with the letrozole group (10.9) with no significance. Conclusion In patients who failed to conceive with CC, gonadotropins have higher pregnancy rates for ovulation induction than letrozole with an insignificant statistical difference.
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促性腺激素与来曲唑对多囊卵巢综合征合并克罗米芬-柠檬酸盐失败患者促排卵作用的比较
背景和目的多囊卵巢综合征(PCOS)是一种影响育龄妇女的内分泌疾病,发病率在8%至13%之间。多囊卵巢综合征是无排卵性不孕的主要原因,不孕妇女的发病率为20%。我们的目的是比较来曲唑和促性腺激素对克罗米芬-柠檬酸盐(CC)失败后多囊卵巢综合征患者的促排卵作用。患者和方法这是一项在爱资哈尔大学侯赛因大学医院进行的前瞻性比较研究;在2020年1月至2021年1月的12个月期间。总共有100名女性被纳入研究,被诊断为多囊卵巢综合征伴排卵性不孕,CC失败后,患者按1:1的比例分为两组。第一组包括50名患者,接受(来曲唑2.5 mg片剂),每天两次。结果促性腺激素组确认排卵的发生率(62%)高于来曲唑组(58%),但无统计学意义。与来曲唑组(30%)相比,促性腺激素组(34%)的确诊妊娠发生率更高,但这一差异在统计学上无统计学意义。结果显示,来曲唑组(13.48)与促性腺激素组(14.55)相比,到触发日的持续时间更短,差异有显著性。促性腺激素组(11.3)在触发当天的子宫内膜厚度高于来曲唑组(10.9),无统计学意义。结论在CC妊娠失败的患者中,促性腺激素诱导排卵的妊娠率高于来曲唑,差异无统计学意义。
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审稿时长
34 weeks
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