Abdellah MS. off label. Apart from OI, letrozole is being utilized for endometriosis and adenomyosis[15,16,17] uterine fibroids,[18] endometrial stromal sarcoma,[19] and medical abortion. [20] This evaluate will focus on use of letrozole for OI. Letrozole has been KDELC1 antibody used in the following three situations: OI in polycystic ovary syndrome (PCOS) OI in intrauterine insemination (IUI) Ovarian activation for IVF/ICSI. LETROZOLE IN PCOS There is extensive literature available on this topic. Since the data is definitely heterogeneous, they have been compared in subgroups: Letrozole versus CC; letrozole versus CC and metformin; letrozole versus ovarian drilling; and letrozole versus anastrozole. Letrozole vs. clomiphene citrate The results of individual randomized controlled tests (RCTs) comparing letrozole with CC have been RG108 presented in Table 1. Overall, ladies with PCOS who have been therapy naive or CC resistant or those without clarification as to whether they were therapy naive or CC resistant, letrozole was better than CC for ovulation rate per patient ( 0.0001).[21] There was no statistical difference between them for ovulation rate per cycle ( 0.37).[21] There was no statistical difference between letrozole and CC for pregnancy rate per patient, miscarriage rate per pregnancy, live birth rate per pregnancy, or multiple pregnancy rates per patient.[21] High heterogeneity in the pregnancy rate was likely due to the difference in quality of the RCTs, which was used to categorize the levels of bias.[21] Table 1 Characteristics of few RCTs comparing letrozole with clomiphene citrate in PCOS women Open in a separate windows Letrozole vs. CC plus metformin Only one RCT by Abu Hashim = 0.02) in the CC group (1.8%) against letrozole group (0.2%). More specifically ventricular septal defect 0.2% in letrozole and 1.8% in CC group. Thus, they concluded that there was no difference in the overall rates of major and minor congenital malformations among newborns conceived after letrozole or CC. Moreover, they concluded that congenital cardiac defects appear less frequently in letrozole group. A recent multicentric study for the national birth defects prevention study, published in Human Reproduction 2011, reported on association between CC use and birth defects.[43] Data from the National Birth Defects Prevention study, a population-based study, was used. Close to 25,000 women with or without children with congenital defects were interviewed. They were specifically asked about CC use in the period from 2 months before conception to the first month of pregnancy. They concluded significantly increased adjusted odds ratio for the use of CC and cardiac anomalies, including septal heart defects, muscular ventricular septal defects, and coarctation of the aorta. Davies activities. Mol Endocrinol. 1989;3:1352C8. [PubMed] [Google Scholar] 11. Weil SJ, Vendola K, Zhou J, Adesanya OO, Wang J, Okafor J, et al. Androgen receiptor gene expression in the primate ovary: Cellular localization, regulation, and functional correlations. J Clin Endocrinol Metab. 1998;837:2479C85. [PubMed] [Google Scholar] 12. Weil S, Vendola K, Zhou J, Bondy CA. Androgen and follicle-stimulating hormone interactions in primate ovarian follicle development. J Clin Endocrinol Metab. 1999;848:2951C6. [PubMed] [Google Scholar] 13. Vendola KA, Zhou J, Adesanya OO, Weil SJ, Bondy CA. Androgens stimulate early stages of follicular growth in the primate ovary. J Clin Invest. 1998;101:2622C9. [PMC free article] [PubMed] [Google Scholar] 14. Legro RS, Kunselman AR, Brzyski RG, Casson PR, Diamond MP, Schlaff WD, et al. NICHD Reproductive Medicine Network. The pregnancy in polycystic ovary syndrome II (PPCOS II) trial: Rationale and design of a double-blind randomized trial of clomiphene citrate and letrozole for the treatment of infertility in women with polycystic ovary syndrome. Contemp Clin Trials. 2012;33:470C81. [PMC free article] [PubMed] [Google Scholar] 15. Dietrich JE. An update on adenomyosis in the adolescent. Curr Opin Obstet Gynecol. 2010;22:388C92. [PubMed] [Google Scholar] 16. Mousa NA, Bedaiwy MA, Casper RF. Aromatase inhibitors in the treatment of severe endometriosis. Obstet Gynecol. 2007;109:1421C3. [PubMed] [Google Scholar] 17. Nawathe A, Patwardhan S, Yates D, Harrison GR, Khan KS. Systematic review of the effects of aromatase inhibitors on pain associated with endometriosis. BJOG. 2008;115:818C22. [PubMed] [Google Scholar] 18. Parsanezhad ME, Azmoon M, Alborzi S, Rajaeefard A, Zarei A, Kazerooni T, et al. A randomized, controlled clinical trial comparing the effects of aromatase inhibitor (letrozole) and gonadotropin-releasing hormone agonist (triptorelin) on uterine leiomyoma volume and hormonal status. Fertil Steril. 2010;93:192C8. [PubMed] [Google Scholar] 19. Sylvestre VT, Dunton CJ. Treatment of recurrent endometrial stromal sarcoma with letrozole: A case report and literature review. Horm.Arch Gynecol Obstet. review will focus on use of letrozole for OI. Letrozole has been used in the following three situations: OI in polycystic ovary syndrome (PCOS) OI in intrauterine insemination (IUI) Ovarian stimulation for IVF/ICSI. LETROZOLE IN PCOS There is extensive literature available on this topic. Since the data is usually heterogeneous, they have been compared in subgroups: Letrozole versus CC; letrozole versus CC and metformin; letrozole versus ovarian drilling; and letrozole versus anastrozole. Letrozole vs. clomiphene citrate The results of individual randomized controlled trials (RCTs) comparing letrozole with CC have been presented in Table 1. Overall, women with PCOS who were therapy naive or CC resistant or those without clarification as to whether they were therapy naive or CC resistant, letrozole was better than CC for ovulation rate per patient ( 0.0001).[21] There was no statistical difference between them for ovulation rate per cycle ( 0.37).[21] There RG108 was no statistical difference between letrozole and CC for pregnancy rate per patient, miscarriage rate per pregnancy, live birth rate per pregnancy, or multiple pregnancy rates per patient.[21] High heterogeneity in the pregnancy rate was likely due to the difference in quality of the RCTs, which was used to categorize the levels of bias.[21] Table 1 Characteristics of few RCTs comparing letrozole with clomiphene citrate in PCOS women Open in a separate windows Letrozole vs. CC plus metformin Only one RCT by Abu Hashim = 0.02) in the CC group (1.8%) against letrozole group (0.2%). More specifically ventricular septal defect 0.2% in letrozole and 1.8% in CC group. Thus, they concluded that there was no difference in the overall rates of major and minor congenital malformations among newborns conceived after letrozole or CC. Moreover, they concluded that congenital cardiac defects appear less frequently in letrozole group. A recent multicentric study for the national birth defects prevention study, published in Human Reproduction 2011, reported on association between CC use and birth RG108 defects.[43] Data from the National Birth Defects Prevention study, a population-based study, was used. Close to 25,000 women with or without children with congenital defects were interviewed. They were specifically asked about CC use in the period from 2 months before conception to the first month of pregnancy. They concluded significantly increased adjusted odds ratio for the use of CC and cardiac anomalies, including septal heart defects, muscular ventricular septal defects, and coarctation of the aorta. Davies activities. Mol Endocrinol. 1989;3:1352C8. [PubMed] [Google Scholar] 11. Weil SJ, Vendola K, Zhou J, Adesanya OO, Wang J, Okafor J, et al. Androgen receiptor gene expression in the primate ovary: Cellular localization, regulation, and functional correlations. J Clin Endocrinol Metab. 1998;837:2479C85. [PubMed] [Google Scholar] 12. Weil S, Vendola K, Zhou J, Bondy CA. Androgen and follicle-stimulating hormone interactions in primate ovarian follicle development. J Clin Endocrinol Metab. 1999;848:2951C6. [PubMed] [Google Scholar] 13. RG108 Vendola KA, Zhou J, Adesanya OO, Weil SJ, Bondy CA. Androgens stimulate early stages of follicular growth in the primate ovary. J Clin Invest. 1998;101:2622C9. [PMC free article] [PubMed] [Google Scholar] 14. Legro RS, Kunselman AR, Brzyski RG, Casson PR, Diamond MP, Schlaff WD, et al. NICHD Reproductive Medicine Network. The pregnancy in polycystic ovary syndrome II (PPCOS II) trial: Rationale and design of a double-blind randomized trial of clomiphene citrate and letrozole for the treatment of infertility in women with polycystic ovary syndrome. Contemp Clin Trials. 2012;33:470C81. [PMC free article] [PubMed] [Google Scholar] 15. Dietrich JE. An update on adenomyosis in the adolescent. Curr Opin Obstet Gynecol. 2010;22:388C92. [PubMed] [Google Scholar] 16. Mousa NA, Bedaiwy MA, Casper RF. Aromatase inhibitors in the treatment of severe endometriosis. Obstet Gynecol. 2007;109:1421C3. [PubMed] [Google Scholar] 17. Nawathe A, Patwardhan S, Yates D, Harrison GR, Khan KS. Systematic review of the effects of aromatase inhibitors on pain associated with endometriosis. BJOG. 2008;115:818C22. [PubMed] [Google Scholar] 18. Parsanezhad ME, Azmoon M, Alborzi S, Rajaeefard A, Zarei A, Kazerooni T, et al. A randomized, controlled clinical trial comparing the effects of aromatase inhibitor (letrozole) and gonadotropin-releasing hormone agonist (triptorelin) on uterine.
Categories