International Journal of Reproductive BioMedicine
Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences of Yazd
Vol. 17, No. 9, 2019, pp. 653-660
Bioline Code: rm19070
Full paper language: English
Document type: Research Article
Document available free of charge
International Journal of Reproductive BioMedicine, Vol. 17, No. 9, 2019, pp. 653-660
© Copyright 2019 - Ashraf Moini et al.
Letrozole as co-treatment agent in ovarian stimulation antagonist protocol in poor responders: A double-blind randomized clinical trial|
Moini, Ashraf; Lavasani, Zohreh; Kashani, Ladan; Mojtahedi, Maryam Farid & Yamini, Nazila
Background: Ovarian stimulation (OS) for poor ovarian response (POR) patients is
still a major challenge in assisted reproductive techniques. Aromatase inhibitors as
co-treatment in antagonist protocol are suggested to these patients, but there are
Objective: To evaluate the effectiveness Letrozole (LZ) as adjuvant treatment
in gonadotropin-releasing hormone (GnRH)-antagonist protocol in POR patients
undergoing in vitro fertilization/intracytoplasmic sperm injection cycles.
Materials and Methods: This double-blind randomized clinical trial was conducted
in Arash women’s hospital. One hundred sixty infertile women with POR based on
Bologna criteria were allocated into two groups randomly: LZ + GnRH-antagonist (LA)
and placebo + GnRH-antagonist (PA) groups. In the experimental group, the patients
received 5 mg LZ on the first five days of OS with 150 IU of recombinant human
follicle-stimulating hormone (rFSH) and 150 IU of human menopausal gonadotropin
(HMG). The cycle outcomes were compared between groups.
Results: The total number of retrieved oocytes and the metaphase II oocytes in
LA-treated group were significantly higher than those in the control group (p = 0.008, p =
0.002). The dosage of hMG used and the duration of OS and antagonist administration
in LZ-treated group were significantly lower than those of the control group. The
number of patients with no oocyte, in the control group, was higher than the LZ-treated
group, and the clinical pregnancy rate in LA-treated group (25%) was higher than the
control group (18%); however, the differences were not significant statistically.
Conclusion: Adding 5 mg of LZ to rFSH/hMG antagonist protocol may improve the in
vitro fertilization/intracytoplasmic sperm injection cycle outcome in POR patients.
Letrozole; Ovarian reserve; Primary ovarian insufficiency; Ovulation induction; Fertilization in vitro; Aromatase inhibitors.
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