The DOI matches its Crossref record; 43 of the 45 references it cites were found in a registry or an index; none of the 23 sources its claims cite is checked for support yet.
Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate
Open accessAbstract
Objective To use aromatase inhibition for induction of ovulation in women in whom clomiphene citrate (CC) treatment was unsuccessful. Design Prospective trial in infertility patients treated with CC. Setting Two tertiary-referral infertility clinics associated with the Division of Reproductive Sciences, University of Toronto. Patient(s) Twelve patients with anovulatory polycystic ovary syndrome (PCOS) and 10 patients with ovulatory infertility, all of whom had previously received CC with an inadequate outcome (no ovulation and/or endometrial thickness of Intervention(s) The aromatase inhibitor letrozole was given orally in a dose of 2.5 mg on days 3-7 after menses. Main outcome measure(s) Occurrence of ovulation, endometrial thickness, and pregnancy rates. Result(s) With CC treatment in patients with PCOS, ovulation occurred in 8 of 18 cycles (44.4%), and all ovulatory cycles for the women included in this study had endometrial thickness of Conclusion(s) Oral administration of the aromatase inhibitor letrozole is effective for ovulation induction in anovulatory infertility and for increased follicle recruitment in ovulatory infertility. Letrozole appears to avoid the unfavorable effects on the endometrium frequently seen with antiestrogen use for ovulation induction.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In ovulatory patients, the serum E 2 level was 719 pmol/L in letrozole treatment cycles versus 3,003 pmol/L in CC treatment cycles.”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > RESULTS
plainn = 10- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the 10 patients with ovulatory infertility, letrozole treatment resulted in a mean number of 2.3 mature follicles and mean endometrial thickness of 0.8 cm.”
- Also stated in: § RESULTS · plain
“The mean number of follicles measuring Ͼ1.5 cm on the day of hCG administration was 2.3 (range, 1-4).”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > Abstract Objective: To use aromatase inhibition for induction of ovulation in women in whom clomiphene citrate (CC) treatment was unsuccessful.Design: Prospective trial in infertility patients treated with CC.Setting: Two tertiary-referral infertility clinics associated with the Division of Reproductive Sciences, University of Toronto.Patient(s): Twelve patients with anovulatory polycystic ovary syndrome (PCOS) and 10 patients with ovulatory infertility, all of whom had previously received CC with an inadequate outcome (no ovulation and/or endometrial thickness of Յ0.5 cm).Intervention(s): The aromatase inhibitor letrozole was given orally in a dose of 2.5 mg on days 3-7 after menses.Main Outcome Measure(s): Occurrence of ovulation, endometrial thickness, and pregnancy rates.Result(s): With CC treatment in patients with PCOS, ovulation occurred in 8 of 18 cycles (44.4%), and all ovulatory cycles for the women included in this study had endometrial thickness of Յ0.5 cm.In 10 ovulatory patients, 15 CC cycles resulted in a mean number of 2.5 mature follicles, but all cycles had endometrial thickness of Յ0.5 cm on the day of hCG administration.With letrozole treatment in the same patients with PCOS, ovulation occurred in 9 of 12 cycles (75%) and pregnancy was achieved in 3 patients (25%).In the 10 patients with ovulatory infertility, letrozole treatment resulted in a mean number of 2.3 mature follicles and mean endometrial thickness of 0.8 cm.Pregnancy was achieved in 1 patient (10%).Conclusion(s): Oral administration of the aromatase inhibitor letrozole is effective for ovulation induction in anovulatory infertility and for increased follicle recruitment in ovulatory infertility.Letrozole appears to avoid the unfavorable effects on the endometrium frequently seen with antiestrogen use for ovulation induction.(Fertil Steril 2001;75:305-9.©2001 by American Society for Reproductive Medicine.) In women with World Health Organization type II anovulatory infertility, the treatment of first choice for the induction of ovulation is an antiestrogen, most commonly clomiphene citrate (CC) (1,2).However, 20%-25% of women are resistant to CC and do not ovulate.In addition, clinical data have revealed a discrepancy between ovulation and conception rates during CC treatment and a higher than expected incidence of miscarriage in conception cycles (3)(4)(5)(6).These observations have been attributed to the antiestrogenic mechanism of action of CC, which involves long-lasting estrogen receptor (ER) depletion.It also appears that CC accumulates in the body because of its long half-life (7).As a result, CC may have a negative effect on the quality and quantity of cervical mucus (8), on endometrial development (9), and on other as yet undetermined fertility factors (10,11). After failure of CC, gonadotropin preparations such as hMG or pure FSH have been used as a second-line treatment for ovulation induction.In women with polycystic ovary syndrome (PCOS), because of the high sensitivity of the ovaries to gonadotropin stimulation, treatment with hMG or pure FSH is difficult to control and characteristically induces several ovulatory follicles, leading to the risk of multiple pregnancies and ovarian hyperstimulation syndrome (OHSS) (12).Therefore, a simple oral treatment that could be used without risk of hyperstimulation and with minimal monitoring would be the preferred therapy.
plaindirectn = 10- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“On the day of hCG administration in patients with PCOS, the mean serum E 2 concentration was 962 pmol/L in letrozole treatment cycles, versus 1,638 pmol/L in CC treatment cycles.”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > RESULTS
plainn = 10- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the 10 patients with ovulatory infertility, letrozole treatment resulted in a mean number of 2.3 mature follicles and mean endometrial thickness of 0.8 cm.”
- Also stated in: § RESULTS · plain
“Mean endometrial thicknesses on the day of hCG administration in patients with PCOS and ovulatory patients was 0.81 and 0.89 cm with letrozole, compared with 0.62 and 0.52 cm in CC treatment cycles, respectively.”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > Abstract Objective: To use aromatase inhibition for induction of ovulation in women in whom clomiphene citrate (CC) treatment was unsuccessful.Design: Prospective trial in infertility patients treated with CC.Setting: Two tertiary-referral infertility clinics associated with the Division of Reproductive Sciences, University of Toronto.Patient(s): Twelve patients with anovulatory polycystic ovary syndrome (PCOS) and 10 patients with ovulatory infertility, all of whom had previously received CC with an inadequate outcome (no ovulation and/or endometrial thickness of Յ0.5 cm).Intervention(s): The aromatase inhibitor letrozole was given orally in a dose of 2.5 mg on days 3-7 after menses.Main Outcome Measure(s): Occurrence of ovulation, endometrial thickness, and pregnancy rates.Result(s): With CC treatment in patients with PCOS, ovulation occurred in 8 of 18 cycles (44.4%), and all ovulatory cycles for the women included in this study had endometrial thickness of Յ0.5 cm.In 10 ovulatory patients, 15 CC cycles resulted in a mean number of 2.5 mature follicles, but all cycles had endometrial thickness of Յ0.5 cm on the day of hCG administration.With letrozole treatment in the same patients with PCOS, ovulation occurred in 9 of 12 cycles (75%) and pregnancy was achieved in 3 patients (25%).In the 10 patients with ovulatory infertility, letrozole treatment resulted in a mean number of 2.3 mature follicles and mean endometrial thickness of 0.8 cm.Pregnancy was achieved in 1 patient (10%).Conclusion(s): Oral administration of the aromatase inhibitor letrozole is effective for ovulation induction in anovulatory infertility and for increased follicle recruitment in ovulatory infertility.Letrozole appears to avoid the unfavorable effects on the endometrium frequently seen with antiestrogen use for ovulation induction.(Fertil Steril 2001;75:305-9.©2001 by American Society for Reproductive Medicine.) In women with World Health Organization type II anovulatory infertility, the treatment of first choice for the induction of ovulation is an antiestrogen, most commonly clomiphene citrate (CC) (1,2).However, 20%-25% of women are resistant to CC and do not ovulate.In addition, clinical data have revealed a discrepancy between ovulation and conception rates during CC treatment and a higher than expected incidence of miscarriage in conception cycles (3)(4)(5)(6).These observations have been attributed to the antiestrogenic mechanism of action of CC, which involves long-lasting estrogen receptor (ER) depletion.It also appears that CC accumulates in the body because of its long half-life (7).As a result, CC may have a negative effect on the quality and quantity of cervical mucus (8), on endometrial development (9), and on other as yet undetermined fertility factors (10,11). After failure of CC, gonadotropin preparations such as hMG or pure FSH have been used as a second-line treatment for ovulation induction.In women with polycystic ovary syndrome (PCOS), because of the high sensitivity of the ovaries to gonadotropin stimulation, treatment with hMG or pure FSH is difficult to control and characteristically induces several ovulatory follicles, leading to the risk of multiple pregnancies and ovarian hyperstimulation syndrome (OHSS) (12).Therefore, a simple oral treatment that could be used without risk of hyperstimulation and with minimal monitoring would be the preferred therapy.
plaindirectn = 10- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No pregnancy was achieved in any of the ovulatory cycles.”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > RESULTS
plainn = 12- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“With letrozole treatment in the same patients with PCOS, ovulation occurred in 9 of 12 cycles (75%) and pregnancy was achieved in 3 patients (25%).”
- Also stated in: § RESULTS · plain
“Pregnancy was achieved in 3 cycles (25%), 2 of which were singleton clinical pregnancies and 1 of which was a chemical pregnancy.”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > Abstract Objective: To use aromatase inhibition for induction of ovulation in women in whom clomiphene citrate (CC) treatment was unsuccessful.Design: Prospective trial in infertility patients treated with CC.Setting: Two tertiary-referral infertility clinics associated with the Division of Reproductive Sciences, University of Toronto.Patient(s): Twelve patients with anovulatory polycystic ovary syndrome (PCOS) and 10 patients with ovulatory infertility, all of whom had previously received CC with an inadequate outcome (no ovulation and/or endometrial thickness of Յ0.5 cm).Intervention(s): The aromatase inhibitor letrozole was given orally in a dose of 2.5 mg on days 3-7 after menses.Main Outcome Measure(s): Occurrence of ovulation, endometrial thickness, and pregnancy rates.Result(s): With CC treatment in patients with PCOS, ovulation occurred in 8 of 18 cycles (44.4%), and all ovulatory cycles for the women included in this study had endometrial thickness of Յ0.5 cm.In 10 ovulatory patients, 15 CC cycles resulted in a mean number of 2.5 mature follicles, but all cycles had endometrial thickness of Յ0.5 cm on the day of hCG administration.With letrozole treatment in the same patients with PCOS, ovulation occurred in 9 of 12 cycles (75%) and pregnancy was achieved in 3 patients (25%).In the 10 patients with ovulatory infertility, letrozole treatment resulted in a mean number of 2.3 mature follicles and mean endometrial thickness of 0.8 cm.Pregnancy was achieved in 1 patient (10%).Conclusion(s): Oral administration of the aromatase inhibitor letrozole is effective for ovulation induction in anovulatory infertility and for increased follicle recruitment in ovulatory infertility.Letrozole appears to avoid the unfavorable effects on the endometrium frequently seen with antiestrogen use for ovulation induction.(Fertil Steril 2001;75:305-9.©2001 by American Society for Reproductive Medicine.) In women with World Health Organization type II anovulatory infertility, the treatment of first choice for the induction of ovulation is an antiestrogen, most commonly clomiphene citrate (CC) (1,2).However, 20%-25% of women are resistant to CC and do not ovulate.In addition, clinical data have revealed a discrepancy between ovulation and conception rates during CC treatment and a higher than expected incidence of miscarriage in conception cycles (3)(4)(5)(6).These observations have been attributed to the antiestrogenic mechanism of action of CC, which involves long-lasting estrogen receptor (ER) depletion.It also appears that CC accumulates in the body because of its long half-life (7).As a result, CC may have a negative effect on the quality and quantity of cervical mucus (8), on endometrial development (9), and on other as yet undetermined fertility factors (10,11). After failure of CC, gonadotropin preparations such as hMG or pure FSH have been used as a second-line treatment for ovulation induction.In women with polycystic ovary syndrome (PCOS), because of the high sensitivity of the ovaries to gonadotropin stimulation, treatment with hMG or pure FSH is difficult to control and characteristically induces several ovulatory follicles, leading to the risk of multiple pregnancies and ovarian hyperstimulation syndrome (OHSS) (12).Therefore, a simple oral treatment that could be used without risk of hyperstimulation and with minimal monitoring would be the preferred therapy.
plaindirectn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Mean endometrial thicknesses on the day of hCG administration in patients with PCOS and ovulatory patients was 0.81 and 0.89 cm with letrozole, compared with 0.62 and 0.52 cm in CC treatment cycles, respectively.”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > RESULTS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Pregnancy was achieved in 1 patient (10%).”
- Also stated in: § RESULTS · plain
“A singleton clinical pregnancy (10%) resulted from timed intrauterine insemination in one couple with unexplained infertility who developed 2 follicles of Ͼ1.5 cm.”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > Abstract Objective: To use aromatase inhibition for induction of ovulation in women in whom clomiphene citrate (CC) treatment was unsuccessful.Design: Prospective trial in infertility patients treated with CC.Setting: Two tertiary-referral infertility clinics associated with the Division of Reproductive Sciences, University of Toronto.Patient(s): Twelve patients with anovulatory polycystic ovary syndrome (PCOS) and 10 patients with ovulatory infertility, all of whom had previously received CC with an inadequate outcome (no ovulation and/or endometrial thickness of Յ0.5 cm).Intervention(s): The aromatase inhibitor letrozole was given orally in a dose of 2.5 mg on days 3-7 after menses.Main Outcome Measure(s): Occurrence of ovulation, endometrial thickness, and pregnancy rates.Result(s): With CC treatment in patients with PCOS, ovulation occurred in 8 of 18 cycles (44.4%), and all ovulatory cycles for the women included in this study had endometrial thickness of Յ0.5 cm.In 10 ovulatory patients, 15 CC cycles resulted in a mean number of 2.5 mature follicles, but all cycles had endometrial thickness of Յ0.5 cm on the day of hCG administration.With letrozole treatment in the same patients with PCOS, ovulation occurred in 9 of 12 cycles (75%) and pregnancy was achieved in 3 patients (25%).In the 10 patients with ovulatory infertility, letrozole treatment resulted in a mean number of 2.3 mature follicles and mean endometrial thickness of 0.8 cm.Pregnancy was achieved in 1 patient (10%).Conclusion(s): Oral administration of the aromatase inhibitor letrozole is effective for ovulation induction in anovulatory infertility and for increased follicle recruitment in ovulatory infertility.Letrozole appears to avoid the unfavorable effects on the endometrium frequently seen with antiestrogen use for ovulation induction.(Fertil Steril 2001;75:305-9.©2001 by American Society for Reproductive Medicine.) In women with World Health Organization type II anovulatory infertility, the treatment of first choice for the induction of ovulation is an antiestrogen, most commonly clomiphene citrate (CC) (1,2).However, 20%-25% of women are resistant to CC and do not ovulate.In addition, clinical data have revealed a discrepancy between ovulation and conception rates during CC treatment and a higher than expected incidence of miscarriage in conception cycles (3)(4)(5)(6).These observations have been attributed to the antiestrogenic mechanism of action of CC, which involves long-lasting estrogen receptor (ER) depletion.It also appears that CC accumulates in the body because of its long half-life (7).As a result, CC may have a negative effect on the quality and quantity of cervical mucus (8), on endometrial development (9), and on other as yet undetermined fertility factors (10,11). After failure of CC, gonadotropin preparations such as hMG or pure FSH have been used as a second-line treatment for ovulation induction.In women with polycystic ovary syndrome (PCOS), because of the high sensitivity of the ovaries to gonadotropin stimulation, treatment with hMG or pure FSH is difficult to control and characteristically induces several ovulatory follicles, leading to the risk of multiple pregnancies and ovarian hyperstimulation syndrome (OHSS) (12).Therefore, a simple oral treatment that could be used without risk of hyperstimulation and with minimal monitoring would be the preferred therapy.
plaindirectSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In 10 ovulatory patients, 15 CC cycles resulted in a mean number of 2.5 mature follicles, but all cycles had endometrial thickness of Յ0.5 cm on the day of hCG administration.”
- Also stated in: § RESULTS · plain
“The mean number of follicles measuring Ͼ1.5 cm on the day of hCG administration was 2.5 follicles (range, 1-5).”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > Abstract Objective: To use aromatase inhibition for induction of ovulation in women in whom clomiphene citrate (CC) treatment was unsuccessful.Design: Prospective trial in infertility patients treated with CC.Setting: Two tertiary-referral infertility clinics associated with the Division of Reproductive Sciences, University of Toronto.Patient(s): Twelve patients with anovulatory polycystic ovary syndrome (PCOS) and 10 patients with ovulatory infertility, all of whom had previously received CC with an inadequate outcome (no ovulation and/or endometrial thickness of Յ0.5 cm).Intervention(s): The aromatase inhibitor letrozole was given orally in a dose of 2.5 mg on days 3-7 after menses.Main Outcome Measure(s): Occurrence of ovulation, endometrial thickness, and pregnancy rates.Result(s): With CC treatment in patients with PCOS, ovulation occurred in 8 of 18 cycles (44.4%), and all ovulatory cycles for the women included in this study had endometrial thickness of Յ0.5 cm.In 10 ovulatory patients, 15 CC cycles resulted in a mean number of 2.5 mature follicles, but all cycles had endometrial thickness of Յ0.5 cm on the day of hCG administration.With letrozole treatment in the same patients with PCOS, ovulation occurred in 9 of 12 cycles (75%) and pregnancy was achieved in 3 patients (25%).In the 10 patients with ovulatory infertility, letrozole treatment resulted in a mean number of 2.3 mature follicles and mean endometrial thickness of 0.8 cm.Pregnancy was achieved in 1 patient (10%).Conclusion(s): Oral administration of the aromatase inhibitor letrozole is effective for ovulation induction in anovulatory infertility and for increased follicle recruitment in ovulatory infertility.Letrozole appears to avoid the unfavorable effects on the endometrium frequently seen with antiestrogen use for ovulation induction.(Fertil Steril 2001;75:305-9.©2001 by American Society for Reproductive Medicine.) In women with World Health Organization type II anovulatory infertility, the treatment of first choice for the induction of ovulation is an antiestrogen, most commonly clomiphene citrate (CC) (1,2).However, 20%-25% of women are resistant to CC and do not ovulate.In addition, clinical data have revealed a discrepancy between ovulation and conception rates during CC treatment and a higher than expected incidence of miscarriage in conception cycles (3)(4)(5)(6).These observations have been attributed to the antiestrogenic mechanism of action of CC, which involves long-lasting estrogen receptor (ER) depletion.It also appears that CC accumulates in the body because of its long half-life (7).As a result, CC may have a negative effect on the quality and quantity of cervical mucus (8), on endometrial development (9), and on other as yet undetermined fertility factors (10,11). After failure of CC, gonadotropin preparations such as hMG or pure FSH have been used as a second-line treatment for ovulation induction.In women with polycystic ovary syndrome (PCOS), because of the high sensitivity of the ovaries to gonadotropin stimulation, treatment with hMG or pure FSH is difficult to control and characteristically induces several ovulatory follicles, leading to the risk of multiple pregnancies and ovarian hyperstimulation syndrome (OHSS) (12).Therefore, a simple oral treatment that could be used without risk of hyperstimulation and with minimal monitoring would be the preferred therapy.
plaindirectn = 10- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Ovulation occurred in 8 cycles (44.4%) with an endometrial thickness of Յ0.5 cm.”
- Also stated in: § Abstract Objective: To use aromatase inhibition for induction of ovulation in women in whom clomiphene citrate (CC) treatment was unsuccessful.Design: Prospective trial in infertility patients treated with CC.Setting: Two tertiary-referral infertility clinics associated with the Division of Reproductive Sciences, University of Toronto.Patient(s): Twelve patients with anovulatory polycystic ovary syndrome (PCOS) and 10 patients with ovulatory infertility, all of whom had previously received CC with an inadequate outcome (no ovulation and/or endometrial thickness of Յ0.5 cm).Intervention(s): The aromatase inhibitor letrozole was given orally in a dose of 2.5 mg on days 3-7 after menses.Main Outcome Measure(s): Occurrence of ovulation, endometrial thickness, and pregnancy rates.Result(s): With CC treatment in patients with PCOS, ovulation occurred in 8 of 18 cycles (44.4%), and all ovulatory cycles for the women included in this study had endometrial thickness of Յ0.5 cm.In 10 ovulatory patients, 15 CC cycles resulted in a mean number of 2.5 mature follicles, but all cycles had endometrial thickness of Յ0.5 cm on the day of hCG administration.With letrozole treatment in the same patients with PCOS, ovulation occurred in 9 of 12 cycles (75%) and pregnancy was achieved in 3 patients (25%).In the 10 patients with ovulatory infertility, letrozole treatment resulted in a mean number of 2.3 mature follicles and mean endometrial thickness of 0.8 cm.Pregnancy was achieved in 1 patient (10%).Conclusion(s): Oral administration of the aromatase inhibitor letrozole is effective for ovulation induction in anovulatory infertility and for increased follicle recruitment in ovulatory infertility.Letrozole appears to avoid the unfavorable effects on the endometrium frequently seen with antiestrogen use for ovulation induction.(Fertil Steril 2001;75:305-9.©2001 by American Society for Reproductive Medicine.) In women with World Health Organization type II anovulatory infertility, the treatment of first choice for the induction of ovulation is an antiestrogen, most commonly clomiphene citrate (CC) (1,2).However, 20%-25% of women are resistant to CC and do not ovulate.In addition, clinical data have revealed a discrepancy between ovulation and conception rates during CC treatment and a higher than expected incidence of miscarriage in conception cycles (3)(4)(5)(6).These observations have been attributed to the antiestrogenic mechanism of action of CC, which involves long-lasting estrogen receptor (ER) depletion.It also appears that CC accumulates in the body because of its long half-life (7).As a result, CC may have a negative effect on the quality and quantity of cervical mucus (8), on endometrial development (9), and on other as yet undetermined fertility factors (10,11). After failure of CC, gonadotropin preparations such as hMG or pure FSH have been used as a second-line treatment for ovulation induction.In women with polycystic ovary syndrome (PCOS), because of the high sensitivity of the ovaries to gonadotropin stimulation, treatment with hMG or pure FSH is difficult to control and characteristically induces several ovulatory follicles, leading to the risk of multiple pregnancies and ovarian hyperstimulation syndrome (OHSS) (12).Therefore, a simple oral treatment that could be used without risk of hyperstimulation and with minimal monitoring would be the preferred therapy. · plain
“With CC treatment in patients with PCOS, ovulation occurred in 8 of 18 cycles (44.4%), and all ovulatory cycles for the women included in this study had endometrial thickness of Յ0.5 cm.”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > RESULTS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Abstract Objective: To use aromatase inhibition for induction of ovulation in women in whom clomiphene citrate (CC) treatment was unsuccessful.Design: Prospective trial in infertility patients treated with CC.Setting: Two tertiary-referral infertility clinics associated with the Division of Reproductive Sciences, University of Toronto.Patient(s): Twelve patients with anovulatory polycystic ovary syndrome (PCOS) and 10 patients with ovulatory infertility, all of whom had previously received CC with an inadequate outcome (no ovulation and/or endometrial thickness of Յ0.5 cm).Intervention(s): The aromatase inhibitor letrozole was given orally in a dose of 2.5 mg on days 3-7 after menses.Main Outcome Measure(s): Occurrence of ovulation, endometrial thickness, and pregnancy rates.Result(s): With CC treatment in patients with PCOS, ovulation occurred in 8 of 18 cycles (44.4%), and all ovulatory cycles for the women included in this study had endometrial thickness of Յ0.5 cm.In 10 ovulatory patients, 15 CC cycles resulted in a mean number of 2.5 mature follicles, but all cycles had endometrial thickness of Յ0.5 cm on the day of hCG administration.With letrozole treatment in the same patients with PCOS, ovulation occurred in 9 of 12 cycles (75%) and pregnancy was achieved in 3 patients (25%).In the 10 patients with ovulatory infertility, letrozole treatment resulted in a mean number of 2.3 mature follicles and mean endometrial thickness of 0.8 cm.Pregnancy was achieved in 1 patient (10%).Conclusion(s): Oral administration of the aromatase inhibitor letrozole is effective for ovulation induction in anovulatory infertility and for increased follicle recruitment in ovulatory infertility.Letrozole appears to avoid the unfavorable effects on the endometrium frequently seen with antiestrogen use for ovulation induction.(Fertil Steril 2001;75:305-9.©2001 by American Society for Reproductive Medicine.) In women with World Health Organization type II anovulatory infertility, the treatment of first choice for the induction of ovulation is an antiestrogen, most commonly clomiphene citrate (CC) (1,2).However, 20%-25% of women are resistant to CC and do not ovulate.In addition, clinical data have revealed a discrepancy between ovulation and conception rates during CC treatment and a higher than expected incidence of miscarriage in conception cycles (3)(4)(5)(6).These observations have been attributed to the antiestrogenic mechanism of action of CC, which involves long-lasting estrogen receptor (ER) depletion.It also appears that CC accumulates in the body because of its long half-life (7).As a result, CC may have a negative effect on the quality and quantity of cervical mucus (8), on endometrial development (9), and on other as yet undetermined fertility factors (10,11). After failure of CC, gonadotropin preparations such as hMG or pure FSH have been used as a second-line treatment for ovulation induction.In women with polycystic ovary syndrome (PCOS), because of the high sensitivity of the ovaries to gonadotropin stimulation, treatment with hMG or pure FSH is difficult to control and characteristically induces several ovulatory follicles, leading to the risk of multiple pregnancies and ovarian hyperstimulation syndrome (OHSS) (12).Therefore, a simple oral treatment that could be used without risk of hyperstimulation and with minimal monitoring would be the preferred therapy. · plain
- It may state two separate claims as one. 10
- The quote only partly states this claim. 1
- Probably not a substantial claim. 8
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At the time of writing, the three clinical pregnancies had resulted in a normal live birth and two ongoing singleton pregnancies.”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > RESULTS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the endometrial thickness was Յ0.5 cm in all cycles, and no pregnancy was achieved.”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > RESULTS
plainn = 10- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Compared with CC, letrozole produced a significantly thicker endometrium on the day of hCG administration despite the significantly lower E 2 levels in both patients with PCOS and the ovulatory patients.”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > FERTILITY & STERILITY
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Aromatase inhibitors have potential as alternatives to, or even replacements for, CC as a first-line treatment for ovulation induction in anovulatory infertility and for augmentation of ovulation in ovulatory infertility patients.”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > FERTILITY & STERILITY
hedgedconditionaln = 10- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Recent data support a stimulatory role for androgens in early follicular growth in primates, in contrast to the inhibitory effect observed in rodents (21).”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > FERTILITY & STERILITY
What the sources say
- Not checked — no full text of the sourcecites [21] Weil, 1998, Androgen receptor gene expression in the primate ovary, J Clin Endocrinol Metab source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“In women with polycystic ovary syndrome (PCOS), because of the high sensitivity of the ovaries to gonadotropin stimulation, treatment with hMG or pure FSH is difficult to control and characteristically induces several ovulatory follicles, leading to the risk of multiple pregnancies and ovarian hyperstimulation syndrome (OHSS) (12).”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > Abstract Objective: To use aromatase inhibition for induction of ovulation in women in whom clomiphene citrate (CC) treatment was unsuccessful.Design: Prospective trial in infertility patients treated with CC.Setting: Two tertiary-referral infertility clinics associated with the Division of Reproductive Sciences, University of Toronto.Patient(s): Twelve patients with anovulatory polycystic ovary syndrome (PCOS) and 10 patients with ovulatory infertility, all of whom had previously received CC with an inadequate outcome (no ovulation and/or endometrial thickness of Յ0.5 cm).Intervention(s): The aromatase inhibitor letrozole was given orally in a dose of 2.5 mg on days 3-7 after menses.Main Outcome Measure(s): Occurrence of ovulation, endometrial thickness, and pregnancy rates.Result(s): With CC treatment in patients with PCOS, ovulation occurred in 8 of 18 cycles (44.4%), and all ovulatory cycles for the women included in this study had endometrial thickness of Յ0.5 cm.In 10 ovulatory patients, 15 CC cycles resulted in a mean number of 2.5 mature follicles, but all cycles had endometrial thickness of Յ0.5 cm on the day of hCG administration.With letrozole treatment in the same patients with PCOS, ovulation occurred in 9 of 12 cycles (75%) and pregnancy was achieved in 3 patients (25%).In the 10 patients with ovulatory infertility, letrozole treatment resulted in a mean number of 2.3 mature follicles and mean endometrial thickness of 0.8 cm.Pregnancy was achieved in 1 patient (10%).Conclusion(s): Oral administration of the aromatase inhibitor letrozole is effective for ovulation induction in anovulatory infertility and for increased follicle recruitment in ovulatory infertility.Letrozole appears to avoid the unfavorable effects on the endometrium frequently seen with antiestrogen use for ovulation induction.(Fertil Steril 2001;75:305-9.©2001 by American Society for Reproductive Medicine.) In women with World Health Organization type II anovulatory infertility, the treatment of first choice for the induction of ovulation is an antiestrogen, most commonly clomiphene citrate (CC) (1,2).However, 20%-25% of women are resistant to CC and do not ovulate.In addition, clinical data have revealed a discrepancy between ovulation and conception rates during CC treatment and a higher than expected incidence of miscarriage in conception cycles (3)(4)(5)(6).These observations have been attributed to the antiestrogenic mechanism of action of CC, which involves long-lasting estrogen receptor (ER) depletion.It also appears that CC accumulates in the body because of its long half-life (7).As a result, CC may have a negative effect on the quality and quantity of cervical mucus (8), on endometrial development (9), and on other as yet undetermined fertility factors (10,11). After failure of CC, gonadotropin preparations such as hMG or pure FSH have been used as a second-line treatment for ovulation induction.In women with polycystic ovary syndrome (PCOS), because of the high sensitivity of the ovaries to gonadotropin stimulation, treatment with hMG or pure FSH is difficult to control and characteristically induces several ovulatory follicles, leading to the risk of multiple pregnancies and ovarian hyperstimulation syndrome (OHSS) (12).Therefore, a simple oral treatment that could be used without risk of hyperstimulation and with minimal monitoring would be the preferred therapy.
What the sources say
- Not checked — no full text of the sourcecites [12] Kettel, 1993, Hypothalamic-pituitary-ovarian response to clomiphene citrate in women with polycystic ovary syndrome, Fertil Steril source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“These aromatase inhibitors have a relatively short half-life compared with CC and therefore would be eliminated from the body rapidly (14,15).”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > Abstract Objective: To use aromatase inhibition for induction of ovulation in women in whom clomiphene citrate (CC) treatment was unsuccessful.Design: Prospective trial in infertility patients treated with CC.Setting: Two tertiary-referral infertility clinics associated with the Division of Reproductive Sciences, University of Toronto.Patient(s): Twelve patients with anovulatory polycystic ovary syndrome (PCOS) and 10 patients with ovulatory infertility, all of whom had previously received CC with an inadequate outcome (no ovulation and/or endometrial thickness of Յ0.5 cm).Intervention(s): The aromatase inhibitor letrozole was given orally in a dose of 2.5 mg on days 3-7 after menses.Main Outcome Measure(s): Occurrence of ovulation, endometrial thickness, and pregnancy rates.Result(s): With CC treatment in patients with PCOS, ovulation occurred in 8 of 18 cycles (44.4%), and all ovulatory cycles for the women included in this study had endometrial thickness of Յ0.5 cm.In 10 ovulatory patients, 15 CC cycles resulted in a mean number of 2.5 mature follicles, but all cycles had endometrial thickness of Յ0.5 cm on the day of hCG administration.With letrozole treatment in the same patients with PCOS, ovulation occurred in 9 of 12 cycles (75%) and pregnancy was achieved in 3 patients (25%).In the 10 patients with ovulatory infertility, letrozole treatment resulted in a mean number of 2.3 mature follicles and mean endometrial thickness of 0.8 cm.Pregnancy was achieved in 1 patient (10%).Conclusion(s): Oral administration of the aromatase inhibitor letrozole is effective for ovulation induction in anovulatory infertility and for increased follicle recruitment in ovulatory infertility.Letrozole appears to avoid the unfavorable effects on the endometrium frequently seen with antiestrogen use for ovulation induction.(Fertil Steril 2001;75:305-9.©2001 by American Society for Reproductive Medicine.) In women with World Health Organization type II anovulatory infertility, the treatment of first choice for the induction of ovulation is an antiestrogen, most commonly clomiphene citrate (CC) (1,2).However, 20%-25% of women are resistant to CC and do not ovulate.In addition, clinical data have revealed a discrepancy between ovulation and conception rates during CC treatment and a higher than expected incidence of miscarriage in conception cycles (3)(4)(5)(6).These observations have been attributed to the antiestrogenic mechanism of action of CC, which involves long-lasting estrogen receptor (ER) depletion.It also appears that CC accumulates in the body because of its long half-life (7).As a result, CC may have a negative effect on the quality and quantity of cervical mucus (8), on endometrial development (9), and on other as yet undetermined fertility factors (10,11). After failure of CC, gonadotropin preparations such as hMG or pure FSH have been used as a second-line treatment for ovulation induction.In women with polycystic ovary syndrome (PCOS), because of the high sensitivity of the ovaries to gonadotropin stimulation, treatment with hMG or pure FSH is difficult to control and characteristically induces several ovulatory follicles, leading to the risk of multiple pregnancies and ovarian hyperstimulation syndrome (OHSS) (12).Therefore, a simple oral treatment that could be used without risk of hyperstimulation and with minimal monitoring would be the preferred therapy.
What the sources say
- Not checked — no full text of the sourcecites [14] Lipton, 1995, Letrozole (CGS 20267), Cancer source
- Not checked — no full text of the sourcecites [15] Iveson, 1993, Phase I study of the oral nonsteroidal aromatase inhibitor CGS 20267 in postmenopausal patients with advanced breast cancer, Cancer Res source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Continuous administration of letrozole up to 5 mg/d produced marked suppression of E 2 , estrone, and estrone sulfate, with very few side effects (14,15).”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > FERTILITY & STERILITY
What the sources say
- Not checked — no full text of the sourcecites [14] Lipton, 1995, Letrozole (CGS 20267), Cancer source
- Not checked — no full text of the sourcecites [15] Iveson, 1993, Phase I study of the oral nonsteroidal aromatase inhibitor CGS 20267 in postmenopausal patients with advanced breast cancer, Cancer Res source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In addition, androgen accumulation in the follicle may stimulate insulin-like growth factor, along with other endocrine and paracrine factors, which may synergize with FSH to promote folliculogenesis (25)(26)(27).”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > FERTILITY & STERILITY
What the sources say
- Not matchedcites (25)(26)(27)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Not matched
In the paper
“The absolute systemic bioavailability of letrozole after oral administration was 100% compared with the same dose given IV (19).”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > FERTILITY & STERILITY
What the sources say
- Not checked — no full text of the sourcecites [19] Sioufi, 1997, Absolute bioavailability of letrozole in healthy post-menopausal women, Biopharm Drug Dispos source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Testosterone was found to augment follicular FSH receptor expression in primates, which suggests that androgens promote follicular growth and estrogen biosynthesis indirectly by amplifying FSH effects (22)(23)(24).”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > FERTILITY & STERILITY
What the sources say
- Not matchedcites (22)(23)(24)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Some investigators have proposed combined CC and low-dose glucocorticoid therapy for the treatment of CCresistant anovulation (28 -31).”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > FERTILITY & STERILITY
What the sources say
- Not checked — no full text of the sourcecites [28] Lobo, 1982, Clomiphene and dexamethasone in women unresponsive to clomiphene alone, Obstet Gynecol
- Not checked — no full text of the sourcecites [29] Singh, 1992, Clomiphene-dexamethasone treatment of clomiphene resistant women with and without the polycystic ovary syndrome, J Reprod Med
- Not checked — no full text of the sourcecites [30] Daly, 1984, A randomized study of dexamethasone in ovulation induction with clomiphene citrate, Fertil Steril source
- Not checked — no full text of the sourcecites [31] Diamant, 1980, Induction of ovulation by combined clomiphene citrate and dexamethasone treatment in clomiphene citrate nonresponders, Eur J Obstet Gynecol Reprod Biol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In addition, clinical data have revealed a discrepancy between ovulation and conception rates during CC treatment and a higher than expected incidence of miscarriage in conception cycles (3)(4)(5)(6).”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > Abstract Objective: To use aromatase inhibition for induction of ovulation in women in whom clomiphene citrate (CC) treatment was unsuccessful.Design: Prospective trial in infertility patients treated with CC.Setting: Two tertiary-referral infertility clinics associated with the Division of Reproductive Sciences, University of Toronto.Patient(s): Twelve patients with anovulatory polycystic ovary syndrome (PCOS) and 10 patients with ovulatory infertility, all of whom had previously received CC with an inadequate outcome (no ovulation and/or endometrial thickness of Յ0.5 cm).Intervention(s): The aromatase inhibitor letrozole was given orally in a dose of 2.5 mg on days 3-7 after menses.Main Outcome Measure(s): Occurrence of ovulation, endometrial thickness, and pregnancy rates.Result(s): With CC treatment in patients with PCOS, ovulation occurred in 8 of 18 cycles (44.4%), and all ovulatory cycles for the women included in this study had endometrial thickness of Յ0.5 cm.In 10 ovulatory patients, 15 CC cycles resulted in a mean number of 2.5 mature follicles, but all cycles had endometrial thickness of Յ0.5 cm on the day of hCG administration.With letrozole treatment in the same patients with PCOS, ovulation occurred in 9 of 12 cycles (75%) and pregnancy was achieved in 3 patients (25%).In the 10 patients with ovulatory infertility, letrozole treatment resulted in a mean number of 2.3 mature follicles and mean endometrial thickness of 0.8 cm.Pregnancy was achieved in 1 patient (10%).Conclusion(s): Oral administration of the aromatase inhibitor letrozole is effective for ovulation induction in anovulatory infertility and for increased follicle recruitment in ovulatory infertility.Letrozole appears to avoid the unfavorable effects on the endometrium frequently seen with antiestrogen use for ovulation induction.(Fertil Steril 2001;75:305-9.©2001 by American Society for Reproductive Medicine.) In women with World Health Organization type II anovulatory infertility, the treatment of first choice for the induction of ovulation is an antiestrogen, most commonly clomiphene citrate (CC) (1,2).However, 20%-25% of women are resistant to CC and do not ovulate.In addition, clinical data have revealed a discrepancy between ovulation and conception rates during CC treatment and a higher than expected incidence of miscarriage in conception cycles (3)(4)(5)(6).These observations have been attributed to the antiestrogenic mechanism of action of CC, which involves long-lasting estrogen receptor (ER) depletion.It also appears that CC accumulates in the body because of its long half-life (7).As a result, CC may have a negative effect on the quality and quantity of cervical mucus (8), on endometrial development (9), and on other as yet undetermined fertility factors (10,11). After failure of CC, gonadotropin preparations such as hMG or pure FSH have been used as a second-line treatment for ovulation induction.In women with polycystic ovary syndrome (PCOS), because of the high sensitivity of the ovaries to gonadotropin stimulation, treatment with hMG or pure FSH is difficult to control and characteristically induces several ovulatory follicles, leading to the risk of multiple pregnancies and ovarian hyperstimulation syndrome (OHSS) (12).Therefore, a simple oral treatment that could be used without risk of hyperstimulation and with minimal monitoring would be the preferred therapy.
What the sources say
- Not matchedcites (3)(4)(5)(6)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In summary, the results of this preliminary study suggest that the aromatase inhibitor letrozole is an orally effective, inexpensive method for stimulating follicular development.”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > FERTILITY & STERILITY
hedgeddirectn = 10- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The subsequent increase in gonadotropin secretion could stimulate ovarian follicle development, as reported previously in the Bonnet monkey (20).”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > FERTILITY & STERILITY
What the sources say
- Not checked — no full text of the sourcecites [20] Shetty, 1997, Effect of estrogen deprivation on the reproductive physiology of male and female primates, J Steroid Biochem Mol Biol source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A 2-month washout period before the letrozole cycles was used to eliminate any posttreatment effect of CC.”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > MATERIALS AND METHODS
plaindirectn = 22- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Endometrial thickness was assessed as we have described previously (9) and as performed routinely in our clinic for the last 10 years.”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > MATERIALS AND METHODS
What the sources say
- Not checked — no full text of the sourcecites [9] Gonen, 1990, Sonographic determination of an adverse effect of clomiphene citrate on endometrial growth, Hum Reprod source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Other investigators have described the use of extended duration and higher doses of CC (32)(33)(34)(35).”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > FERTILITY & STERILITY
What the sources say
- Not matchedcites (32)(33)(34)(35)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Identical criteria were used for administration of hCG in both the CC-and letrozole-treated cycles.”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > MATERIALS AND METHODS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The paper relies on this without support.
20%-25% of women are resistant to CC and do not ovulate.
“However, 20%-25% of women are resistant to CC and do not ovulate.”
The paper relies on this without support.
Letrozole is a specific, reversible, nonsteroidal aromatase inhibitor that suppresses estrogen biosynthesis.
“Letrozole (4,4Ј-[1H-1, 2, 4-triazol-1-ylmethylene]-bis-benzonitrile) is a specific, reversible, nonsteroidal aromatase inhibitor that suppresses estrogen biosynthesis.”
The paper relies on this without support.
The disposition of letrozole in healthy postmenopausal women is characterized by steady-state plasma concentrations in 4-8 hours and a half-life of approximately 45 hours.
“The disposition of letrozole in healthy postmenopausal women is characterized by steady-state plasma concentrations in 4 -8 hours and a half-life of approximately 45 hours.”
The paper relies on this without support.
CC is the most commonly prescribed medication for ovulation induction.
“CC is the most commonly prescribed medication for ovulation induction.”
The paper relies on this without support.
Women with ovulatory disorders who are resistant to standard doses of CC generally become candidates for gonadotropin therapy.
“Women with ovulatory disorders who are resistant to standard doses of CC generally become candidates for gonadotropin therapy.”
The paper relies on this without support.
Severe OHSS and the high risk of multiple pregnancy are major disadvantages of gonadotropin treatment, especially in young women with PCOS.
“However, severe OHSS and the high risk of multiple pregnancy are major disadvantages of gonadotropin treatment, especially in young women with PCOS.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Aromatase inhibitors were proposed as ovulation-inducing agents in 2001. 236”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [236]
In the citing paper
“Ovulation induction with letrozole is associated with an ovulation rate of 70%-84% and a pregnancy rate of 20%-27% per cycle.”
From A new era in ovulation induction (2006) · cites this paper as [50]
In the citing paper
“In a small study (50), 12 PCOS patients with inadequate response to CC were treated with letrozole.Of 12 patients, 9 (75%) ovulated, and 3 conceived; the mean endometrial thickness was 8.1 mm (6.2 mm with CC).”
From A new era in ovulation induction (2006) · cites this paper as [50]
In the citing paper
“Recently, it was suggested that letrozole, a specific reversible, nonsteroidal aromatase inhibitor that suppresses estrogen biosynthesis (16), can successfully replace clomiphene citrate in superovulation treatment of patients with unexplained infertility or polycystic ovarian disease and in poor responders (17,18).”
From Effects of letrozole on superovulation with gonadotropins in women undergoing intrauterine insemination (2003) · cites this paper as [17]
In the citing paper
“Two doses regimens have been tested (2.5 mg and 5 mg) with similar response (8,9).”
From A randomized trial of letrozole versus clomiphene citrate in women undergoing superovulation (2004) · cites this paper as [8]
In the citing paper
“Mitwally and Casper (8) used letrozole (2.5 mg daily for 5 days) in 12 women with inadequate response to CC. Ovulation occurred in 9 of 12 cycles and 3 patients conceived.”
From A randomized trial of letrozole versus clomiphene citrate in women undergoing superovulation (2004) · cites this paper as [8]
In the citing paper
“The ideal dose of letrozole for superovulation or ovulation induction is still unknown.”
From A randomized trial of letrozole versus clomiphene citrate in women undergoing superovulation (2004) · cites this paper as [8]
In the citing paper
“Compared with CC, letrozole is associated with a thicker endometrium (8).”
From A randomized trial of letrozole versus clomiphene citrate in women undergoing superovulation (2004) · cites this paper as [8]
In the citing paper
“In a selected population of women with a thin endometrium (mean, 5 mm) after clomiphene treatment, letrozole treatment in the early follicular phase resulted in a significant increase in midcycle endometrial thickness (mean, 9 mm) (21).”
From A randomized double-blind comparison of the effects of clomiphene citrate and the aromatase inhibitor letrozole on ovulatory function in normal women (2002) · cites this paper as [21]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > RESULTS
“Ovulation occurred in 8 cycles (44.4%) with an endometrial thickness of Յ0.5 cm.”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > DISCUSSION
“Endometrial thickness (cm) on day of hCG 0.81 Ϯ 0.14 0.62 Ϯ 0.25 Ͻ.01 0.7-1.1 0.3-1.20.8 0.6”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > RESULTS
“However, the endometrial thickness was Յ0.5 cm in all cycles, and no pregnancy was achieved.”
§ Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate > FERTILITY & STERILITY
“Endometrial thickness (cm) on day of hCG 0.89 Ϯ 0.12 0.5 Ϯ 0.1 Ͻ.001 0.7-1.1 0.3-0.6 0.9 0.5”
Citations
Cites
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Androgens stimulate early stages of follicular growth in the primate ovary
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Androgen and follicle stimulating hormone interactions in primate ovarian follicle development
Weil, S., Vendola, K., Zhou, J., & Bondy, C. A. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.8.5929 · Cited by 592
Insulin-Like Growth Factors and Ovarian Follicular Development*
Giudice, L. C. (1992) · Endocrine Reviews · doi:10.1210/edrv-13-4-641 · Cited by 521
Weil, S. J., Vendola, K., Zhou, J., Adesanya, O. O., Wang, J., Okafor, J., & Bondy, C. A. (1998) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.83.7.4917 · Cited by 359
Vendola, K., Zhou, J., Wang, J., Famuyiwa, O. A., Bievre, M., & Bondy, C. A. (1999) · Biology of Reproduction · doi:10.1095/biolreprod61.2.353 · Cited by 324
Effect of estrogen deprivation on the reproductive physiology of male and female primates
Shetty, G., Krishnamurthy, H., Krishnamurthy, H. N., Bhatnagar, A. S., & Moudgal, R. N. (1997) · The Journal of Steroid Biochemistry and Molecular Biology · doi:10.1016/s0960-0760(97)80008-8 · Cited by 306
Dunaif, A., Heindel, J. J., & Chang, R. (2002) · CRC Press eBooks · doi:10.3109/9780203910948 · Cited by 283
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Research works printed but not linked: 1
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Diagnosis and Management of Infertility: A Review
Carson, S. A., & Kallen, A. N. (2021) · JAMA · doi:10.1001/jama.2021.4788 · Cited by 1,294
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The Science behind 25 Years of Ovarian Stimulation for in Vitro Fertilization
Macklon, N., Stouffer, R. L., Giudice, L. C., & Fauser, B. C. J. M. (2006) · Endocrine Reviews · doi:10.1210/er.2005-0015 · Cited by 572
Aromatase inhibition improves ovarian response to follicle-stimulating hormone in poor responders
Mitwally, M. F. M., & Casper, R. F. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(01)03280-0 · Cited by 407
Self-citationA meta-analysis of outcomes of conventional IVF in women with polycystic ovary syndrome
Heijnen, E., Eijkemans, M. J. C., Hughes, E. G., Laven, J. S. E., Macklon, N., & Fauser, B. C. J. M. (2005) · Human Reproduction Update · doi:10.1093/humupd/dmi036 · Cited by 387
“…different strategies generating mono-ovulatory cycles have recently been emphasized, including weight reduction and life style changes, insulin sensitizers (Lord et al., 2003), aromatase inhibitors (Mitwally and Casper, 2001) and laparoscopic electrocautery of ovaries (Farquhar et al., 2001).”
BackgroundAssessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline
Teede, H. J., Misso, M. L., Deeks, A. A., Moran, L. J., Stuckey, B. G. A., Wong, J. L. A., Norman, R. J., Costello, M. F., & Groups, O. B. O. T. G. D. (2011) · Medical Journal of Australia · doi:10.5694/mja11.10915 · Cited by 379
Tulandi, T., Martin, J., Al-Fadhli, R., Kabli, N., Forman, R., Hitkari, J., Librach, C., Greenblatt, E., & Casper, R. F. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2006.03.014 · Cited by 370
Self-citationGoswami, S. K. (2004) · Human Reproduction · doi:10.1093/humrep/deh359 · Cited by 372
“Letrozole, a highly selective, non-steroidal aromatase inhibitor, could successfully induce ovulation in women with polycystic ovary syndrome (PCOS) (Mitwally and Casper, 2000), including even those who were resistant to clomiphene citrate (Mitwally and Casper, 2001).”
BackgroundInfluentialFisher, S. A., Reid, R. L., Van Vugt, D. A., & Casper, R. F. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(02)03241-7 · Cited by 347
Self-citationMitwally, M. F. M. (2003) · Human Reproduction · doi:10.1093/humrep/deg311 · Cited by 344
Self-citationClomiphene citrate—end of an era? a mini-review
Homburg, R. (2005) · Human Reproduction · doi:10.1093/humrep/dei042 · Cited by 332
“It has been hypothesized, in particular by Mitwally and Casper (2001), that the efficient estrogen-lowering properties of the aromatase inhibitors could be utilized to temporarily release the hypothalamus from the negative feedback effect of estrogen so inducing an increased discharge of FSH.”
BackgroundAromatase Inhibitors for Ovulation Induction
Casper, R. F., & Mitwally, M. F. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2005-1923 · Cited by 272
Self-citationSingle-dose administration of an aromatase inhibitor for ovarian stimulation
Mitwally, M. F., & Casper, R. F. (2005) · Fertility and Sterility · doi:10.1016/j.fertnstert.2004.07.952 · Cited by 272
Self-citationClomiphene citrate versus letrozole for ovarian stimulation: a pilot study
Fatemi, H. M., Kolibianakis, E. M., Tournaye, H. J., Camus, M., Steirteghem, A. V., & Devroey, P. (2003) · Reproductive BioMedicine Online · doi:10.1016/s1472-6483(10)62070-6 · Cited by 253
“Letrozole has so far been used in patients with an inadequate response to CC (Mitwally and Casper, 2001) and has been shown to improve the ovarian response to FSH in poor responders (Mitwally and Casper, 2002).”
BackgroundAilawadi, R., Jobanputra, S., Kataria, M., Gürateş, B., & Bulun, S. E. (2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2003.09.029 · Cited by 233
Soysal, S. (2004) · Human Reproduction · doi:10.1093/humrep/deh035 · Cited by 227
“Aromatase inhibitors given alone are not able to completely inhibit ovarian steroidogenesis (Vignali et al., 2002), and, furthermore, may increase follicular recruitment (Mitwally and Casper, 2001) and may lead to ovarian stimulation and cyst formation.”
BackgroundInfluentialAromatase inhibitors (letrozole) for subfertile women with polycystic ovary syndrome
Franik, S., Eltrop, S., Kremer, J. A. M., Kiesel, L., & Farquhar, C. M. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010287.pub3 · Cited by 208
Ovarian feedback, mechanism of action and possible clinical implications
Messinis, I. E. (2006) · Human Reproduction Update · doi:10.1093/humupd/dml020 · Cited by 207
“An attenuation of the negative feedback effect in women can be also achieved with the use of aromatase inhibitors (Mitwally and Casper, 2001).”
BackgroundSmith, I. E., Dowsett, M., Yap, Y. S., Walsh, G., Lønning, P. E., Santen, R. J., & Hayes, D. F. (2006) · Journal of Clinical Oncology · doi:10.1200/jco.2005.05.3694 · Cited by 203
Mild ovarian stimulation for IVF
Verberg, M. F. G., Macklon, N., Nargund, G., Frydman, R., Devroey, P., Broekmans, F. J., & Fauser, B. C. J. M. (2008) · Human Reproduction Update · doi:10.1093/humupd/dmn056 · Cited by 193
“However, compared with CC they offer the potential advantage of not causing depletion of estrogen receptors (Mitwally and Casper 2001, 2003) and are more rapidly cleared from the body because of their shorter half-life (45 h instead of a few weeks).”
BackgroundA new era in ovulation induction
Holzer, H., Casper, R., & Tulandi, T. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2005.05.078 · Cited by 194
Self-citationClomiphene and anti-oestrogens for ovulation induction in PCOS
Brown, J., Farquhar, C. M., Beck, J., Boothroyd, C. V., & Hughes, E. G. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002249.pub4 · Cited by 193
Aromatase inhibitors: the next generation of therapeutics for endometriosis?
Attar, E., & Bulun, S. E. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2005.09.064 · Cited by 184
Pregnancy outcome after the use of an aromatase inhibitor for ovarian stimulation
Mitwally, M. F., Biljan, M. M., & Casper, R. F. (2005) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2004.08.013 · Cited by 186
Self-citationPolycystic ovary syndrome throughout a woman’s life
Group of interest in Reproductive Endocrinology (GIER) of the Spanish Fertility Society (SEF), Bellver, J., Rodríguez-Tabernero, L., Robles, A., Muñoz, E., Martínez, F., Landeras, J., García-Velasco, J., Fontes, J., Álvarez, M., et al. (2018) · Journal of Assisted Reproduction and Genetics · doi:10.1007/s10815-017-1047-7 · Cited by 180
“5mg/day for 5 to 10 days starting 3–7 days after menses [79].”
BackgroundSheela, N. R., Muthu, S., & Sampathkrishnan, S. (2013) · Spectrochimica Acta Part A Molecular and Biomolecular Spectroscopy · doi:10.1016/j.saa.2013.10.007 · Cited by 177
Pregnancy outcome after the use of an aromatase inhibitor for ovarian stimulation
Mitwally, M. F., & Casper, R. F. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(02)03975-4 · Cited by 178
Self-citationA randomized trial of letrozole versus clomiphene citrate in women undergoing superovulation
Al-Fozan, H., Al-Khadouri, M., Tan, S. L., & Tulandi, T. (2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2004.04.070 · Cited by 174
Haynes, B. P., Dowsett, M., Miller, W. R., Dixon, J. M., & Bhatnagar, A. S. (2003) · The Journal of Steroid Biochemistry and Molecular Biology · doi:10.1016/s0960-0760(03)00384-4 · Cited by 168
Parsanezhad, M. E., Azmoon, M., Alborzi, S., Rajaeefard, A., Zarei, A., Kazerooni, T., Frank, V., & Schmidt, E. H. (2010) · Fertility and Sterility · doi:10.1016/j.fertnstert.2008.09.064 · Cited by 149
Eijkemans, M. J. C. (2003) · Human Reproduction · doi:10.1093/humrep/deg459 · Cited by 142
“…treatment options such as the insulinsensitizing agents (Glueck et al., 2002; Heard et al., 2002; Nestler et al., 2002), aromatase inhibitors (Mitwally and Casper, 2001), laparoscopic surgery of the ovaries (Cohen, 1996; Farquhar et al., 2001) or assisted reproduction such as intrauterine…”
BackgroundOvulation induction: a mini review
Messinis, I. E. (2005) · Human Reproduction · doi:10.1093/humrep/dei128 · Cited by 140
“4%) treated with clomiphene, while endometrium on the day of HCG administration was thicker in the letrozole group (Mitwally and Casper, 2001).”
BackgroundAtay, V., Çam, Ç., Muhçu, M., Cam, M., & Karateke, A. (2006) · Journal of International Medical Research · doi:10.1177/147323000603400109 · Cited by 138
Wang, R., Li, W., Bordewijk, E. M., Legro, R. S., Zhang, H., Wu, X., Gao, J., Morin-Papunen, L. C., Homburg, R., König, T. E., et al. (2019) · Human Reproduction Update · doi:10.1093/humupd/dmz029 · Cited by 142
Badawy, A., Aal, I. A., & Abulatta, M. (2007) · Fertility and Sterility · doi:10.1016/j.fertnstert.2007.02.062 · Cited by 133
RetractedHomburg, R. (2007) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2007.07.009 · Cited by 141
Healey, S., Tan, S. L., Tulandi, T., & Biljan, M. M. (2003) · Fertility and Sterility · doi:10.1016/j.fertnstert.2003.03.001 · Cited by 132
Random-start ovarian stimulation in patients with cancer
Çakmak, H., & Rosen, M. P. (2015) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/gco.0000000000000180 · Cited by 129
“Centrally, aromatase inhibitors release the hypothalamic/pituitary axis from estrogenic negative feedback, increase the secretion of FSH by the pituitary gland, stimulate follicle growth, and, thereby, can be used for ovulation induction [24].”
BackgroundAromatase inhibitors for subfertile women with polycystic ovary syndrome
Franik, S., Kremer, J. A. M., Nelen, W. L. D. M., & Farquhar, C. M. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010287.pub2 · Cited by 125
Endometriosis: novel etiopathogenetic concepts and clinical perspectives
Vignali, M., Infantino, M. S., Matrone, R., Chiodo, I., Somigliana, E., Busacca, M., & Viganò, P. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(02)03233-8 · Cited by 120
Costello, M., Misso, M. L., Balen, A. H., Boyle, J., Devoto, L., Garad, R. M., Hart, R. J., Johnson, L., Jordan, C., Legro, R. S., et al. (2018) · Human Reproduction Open · doi:10.1093/hropen/hoy021 · Cited by 128
Aromatase inhibitors for the treatment of infertility
Mitwally, M. F., & Casper, R. F. (2003) · Expert Opinion on Investigational Drugs · doi:10.1517/13543784.12.3.353 · Cited by 120
“The success of aromatase inhibition in inducing and augmenting ovulation encouraged us to try an aromatase inhibitor in cases of CC failure and we were successful in achieving ovulation and pregnancy [93,94].”
BackgroundInfluentialSelf-citationInfertility management in women with polycystic ovary syndrome: a review
Cunha, A., & Póvoa, A. M. (2021) · Porto Biomedical Journal · doi:10.1097/j.pbj.0000000000000116 · Cited by 123
“3 Letrozole has relatively short half-life (approximately 45 hours) compared to CC, so adverse effects on estrogen target tissues are not expected.(29)”
BackgroundMethodOvarian stimulation in cancer patients
Çakmak, H., & Rosen, M. P. (2013) · Fertility and Sterility · doi:10.1016/j.fertnstert.2013.03.029 · Cited by 117
“Centrally, aromatase inhibitors release the hypothalamicpituitary axis from estrogenic negative feedback, increase the secretion of FSH by the pituitary gland, stimulate follicle growth, and, thereby, can be used for ovulation induction (45).”
BackgroundAmer, S. A. K. S., Smith, J. A., Mahran, A., Fox, P., & Fakis, A. (2017) · Human Reproduction · doi:10.1093/humrep/dex227 · Cited by 122
Comparison of two aromatase inhibitors in women with clomiphene‐resistant polycystic ovary syndrome
Al‐Omari, W. R., Sulaiman, W. R., & Al‐Hadithi, N. (2004) · International Journal of Gynecology & Obstetrics · doi:10.1016/j.ijgo.2003.11.010 · Cited by 113
Polycystic ovary syndrome and infertility: an update
Zehravi, M., Maqbool, M., & Ara, I. (2021) · International Journal of Adolescent Medicine and Health · doi:10.1515/ijamh-2021-0073 · Cited by 124
Azim, A. A., & Oktay, K. (2007) · Fertility and Sterility · doi:10.1016/j.fertnstert.2006.12.068 · Cited by 108
Begum, M. R., Ferdous, J., Begum, A., & Quadir, E. (2008) · Fertility and Sterility · doi:10.1016/j.fertnstert.2007.08.044 · Cited by 109
Kar, S. (2012) · Journal of Human Reproductive Sciences · doi:10.4103/0974-1208.106338 · Cited by 108
“It has been in use for few years now, and numbers of researchers have studied this molecule as an option for ovulation induction.[8,10] Letrozole acts by reducing estrogen production by blocking androgens to estrogens conversion.”
BackgroundSchoolcraft, W. B., Surrey, E. S., Minjarez, D. A., Stevens, J. M., & Gardner, D. K. (2007) · Fertility and Sterility · doi:10.1016/j.fertnstert.2007.02.013 · Cited by 103
Azim, A. A., Costantini-Ferrando, M. F., Lostritto, K., & Oktay, K. (2007) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-0247 · Cited by 101
Aromatase and Its Inhibitors: Significance for Breast Cancer Therapy
Simpson, E. R. (2002) · Recent Progress in Hormone Research · doi:10.1210/rp.57.1.317 · Cited by 102
“However, successful use of letrozole in ovulation induction in women with anovulatory infertility recently was reported (Mitwally and Casper, 2001).”
BackgroundMitwally, M. F. M., & Casper, R. F. (2004) · Journal of the Society for Gynecologic Investigation · doi:10.1016/j.jsgi.2004.03.006 · Cited by 102
Self-citationBayar, Ü., Başaran, M., Kıran, S., Coşkun, A., & Gezer, Ş. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2006.04.026 · Cited by 100
Clomiphene and other antioestrogens for ovulation induction in polycystic ovarian syndrome
Brown, J., & Farquhar, C. M. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002249.pub5 · Cited by 103
Casper, R. F., & Mitwally, M. F. (2011) · Clinical Obstetrics & Gynecology · doi:10.1097/grf.0b013e3182353d0f · Cited by 99
Self-citationReddy, J., & Oktay, K. (2012) · Fertility and Sterility · doi:10.1016/j.fertnstert.2012.09.022 · Cited by 99
Sohrabvand, F., Ansari, S., & Bagheri, M. (2006) · Human Reproduction · doi:10.1093/humrep/del020 · Cited by 97
“, 2002) and have negative effects on the quality or quantity of the cervical and endometrial mucosa (Mitwally and Casper, 2001).”
BackgroundInfluentialFertility Preservation in Women With Breast Cancer
Rodriguez‐Wallberg, K. A., & Oktay, K. (2010) · Clinical Obstetrics & Gynecology · doi:10.1097/grf.0b013e3181f96e00 · Cited by 96
“Ovulation induction with aromatase inhibitors has been described in clomipheneresistant patients with polycystic ovarian syndrome.(25) Aromatase inhibitors have a relatively short life of about 40 hours, therefore, the effects on the pituitary are not long-lasting and down-regulation of the pituitary does not occur wh…”
BackgroundAromatase inhibitors for PCOS: a systematic review and meta-analysis
Misso, M. L., Wong, J. L. A., Teede, H. J., Hart, R. J., Rombauts, L. J. F., Melder, A., Norman, R. J., & Costello, M. (2012) · Human Reproduction Update · doi:10.1093/humupd/dms003 · Cited by 96
Letrozole vs. clomiphene citrate in patients with ovulatory infertility
Bayar, Ü., Tanriverdi, H. A., Barut, A., Ayoğlu, F. N., Özcan, O., & Kaya, E. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2005.09.045 · Cited by 93
“Mitwally and asper (4) have reported the use of letrozole in 12 patients ith polycystic ovary syndrome (PCOS) and 10 patients ith ovulatory infertility.”
BackgroundInfluentialCortínez, A., Carvalho, I. D., Vantman, D., Gabler, F., Íñiguez, G., & Vega, M. (2005) · Fertility and Sterility · doi:10.1016/j.fertnstert.2004.05.099 · Cited by 92
Roy, K., Baruah, J., Singla, S., Sharma, J., Singh, N., Jain, S. K., & Goyal, M. (2012) · Journal of Human Reproductive Sciences · doi:10.4103/0974-1208.97789 · Cited by 95
Ovulation Induction in Polycystic Ovary Syndrome
Vause, T. D. R., Cheung, A. P., Cheung, A. P., Sierra, S., Claman, P., Graham, J., Guillemin, J.-A., Lapensée, L., Steward, S., Vause, T. D. R., et al. (2010) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/s1701-2163(16)34504-2 · Cited by 97
Oral anti-oestrogens and medical adjuncts for subfertility associated with anovulation
Brown, J., Farquhar, C. M., Beck, J., Boothroyd, C. V., Proctor, M. L., & Hughes, E. G. (2005) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002249.pub3 · Cited by 89
Pathogenesis of polycystic ovary syndrome: what is the role of obesity?
Salehi, M., Bravo-Vera, R., Sheikh, A., Gouller, A., & Poretsky, L. (2004) · Metabolism · doi:10.1016/j.metabol.2003.10.005 · Cited by 90
Badawy, A., Shokeir, T. A., ALLAM, A. F., & Abdel‐Hady, H. (2008) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1080/00016340802638199 · Cited by 90
The management of infertility associated with polycystic ovary syndrome
Homburg, R. (2003) · Reproductive Biology and Endocrinology · doi:10.1186/1477-7827-1-109 · Cited by 87
Aromatase inhibitors in ovulation induction
(2004) · Seminars in Reproductive Medicine · doi:10.1055/s-2004-823028 · Cited by 87
“Table 7 shows a comparison between the characteristics of the aromatase inhibitor letrozole and CC treatment cycles in ovulatory patients.(72) Fig.”
BackgroundSelf-citationThe treatment of infertility in polycystic ovary syndrome: a brief update
Costello, M., Misso, M. L., Wong, J., Hart, R. J., Rombauts, L. J. F., Melder, A., Norman, R. J., & Teede, H. J. (2012) · Australian and New Zealand Journal of Obstetrics and Gynaecology · doi:10.1111/j.1479-828x.2012.01448.x · Cited by 85
Endometriosis from thelarche to midteens: pathogenesis and prognosis, prevention and pedagogy
Batt, R. E., & Mitwally, M. F. (2003) · Journal of Pediatric and Adolescent Gynecology · doi:10.1016/j.jpag.2003.09.008 · Cited by 85
Self-citationThe Physiology and Pathology of the Female Reproductive Axis
Bulun, S. E., Adashi, E. Y., & Bulun, S. E. (2007) · Time to knit · doi:10.1016/b978-1-4160-2911-3.50018-2 · Cited by 84
Inhibition of aromatase: insights from recent studies
Santen, R. J. (2003) · Steroids · doi:10.1016/s0039-128x(03)00096-5 · Cited by 83
Ovulation induction in perspective
Homburg, R. (2002) · Human Reproduction Update · doi:10.1093/humupd/8.5.449 · Cited by 83
“It has been shown to be effective, in early trials, in inducing ovulation and pregnancy in women with anovulatory PCOS and inadequate clomiphene response (Mitwally and Casper, 2001a) and improving ovarian response to FSH in poor responders (Mitwally and Casper, 2001b).”
BackgroundHomburg, R. (2004) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2004.05.006 · Cited by 83
A randomized trial of superovulation with two different doses of letrozole
Al-Fadhli, R., Sylvestre, C. V., Buckett, W. M., Tan, S. L., & Tulandi, T. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2005.07.1283 · Cited by 84
Use of aromatase inhibitors in poor-responder patients receiving GnRH antagonist protocols
Özmen, B., Sönmezer, M., Atabekoğlu, C. S., & Olmuş, H. (2009) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2009.05.007 · Cited by 82
“Aromatase inhibitors have been introduced as an alternative ovulation induction agent either alone (Mitwally and Casper, 2001) or as an adjunctive ovulation induction agent along with gonadotrophins in ovarian stimulation (Mitwally and Casper, 2003).”
BackgroundShozu, M., Murakami, K., Segawa, T., Kasai, T., & Inoue, M. (2003) · Fertility and Sterility · doi:10.1016/s0015-0282(02)04761-1 · Cited by 79
Dowsett, M., & Haynes, B. P. (2003) · The Journal of Steroid Biochemistry and Molecular Biology · doi:10.1016/s0960-0760(03)00365-0 · Cited by 79
Ganesh, A., Goswami, S. K., Chattopadhyay, R., Chaudhury, K., & Chakravarty, B. (2009) · Journal of Assisted Reproduction and Genetics · doi:10.1007/s10815-008-9284-4 · Cited by 79
“Letrozole, a highly selective AI, has been found to be effective in inducing ovulation in anovulatory and ovulatory infertile women with inadequate response to CC [14, 15].”
BackgroundDrug treatments for polycystic ovary syndrome.
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Badawy, A., Mosbah, A., & Shady, M. (2008) · Fertility and Sterility · doi:10.1016/j.fertnstert.2007.05.010 · Cited by 76
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Mukherjee, A. G., Wanjari, U. R., Nagarajan, D., Vibhaa, K. K., Anagha, V., Joshua Paul, P., Thirumoorthy, T. P., Chakraborty, R., Renu, K., Dey, A., et al. (2022) · Life Sciences · doi:10.1016/j.lfs.2022.121074 · Cited by 81
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Estrogen Biosynthesis and Signal Transduction in Ovarian Disease
Xu, X.-L., Huang, Z., Yu, K., Li, J., Fu, X., & Deng, S. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.827032 · Cited by 91
Letrozole for ovulation induction and controlled ovarian hyperstimulation
Pritts, E. A. (2010) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/gco.0b013e32833beebf · Cited by 76
Meta-analysis of letrozole versus clomiphene citrate in polycystic ovary syndrome
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“In 2001, an aromatase inhibitor – letrozole, which was used to treat and prevent breast cancer – was first reported to be effective for ovulation induction and appeared to avoid the unfavourable effects of clomiphene citrate and gonadotrophin (Mitwally and Casper, 2001).”
BackgroundTreatment strategies for endometriosis
Rodgers, A. K., & Falcone, T. (2008) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.9.2.243 · Cited by 72
“Stimulating the ovary leads to an increased number of mature follicles [72] .”
BackgroundPredictive factors for intrauterine insemination outcomes: a review
Starosta, A., Gordon, C. E., & Hornstein, M. D. (2020) · Fertility Research and Practice · doi:10.1186/s40738-020-00092-1 · Cited by 71
Aromatase inhibition for ovarian stimulation: future avenues for infertility management
Mitwally, M. F., & Casper, R. F. (2002) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/00001703-200206000-00003 · Cited by 71
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Aromatase inhibitors in ovarian stimulation for IVF/ICSI: a pilot study
Verpoest, W., Kolibianakis, E. M., Papanikolaou, E. G. E., Smitz, J. E. J., Steirteghem, A. V., & Devroey, P. (2006) · Reproductive BioMedicine Online · doi:10.1016/s1472-6483(10)60611-6 · Cited by 70
Action of aromatase inhibitor for treatment of uterine leiomyoma in perimenopausal patients
Hilário, S. G., Bozzini, N., Borsari, R., et al. (2008) · Fertility and Sterility · doi:10.1016/j.fertnstert.2007.11.006 · Cited by 69
Roque, M., Tostes, A. C. I., Valle, M., Sampaio, M. A. C., & Geber, S. (2015) · Gynecological Endocrinology · doi:10.3109/09513590.2015.1096337 · Cited by 67
“ovulation inductor in 2001 in anovulatory women who failed to ovulate with the use of CC, or those who ovulated but did not conceive because of an endometrial thickness 56 mm [11].”
BackgroundElnashar, A. M., Fouad, H., Eldosoky, M., & Saeid, N. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2005.08.016 · Cited by 67
Legro, R. S., Kunselman, A. R., Brzyski, R. G., Casson, P. R., Diamond, M. P., Schlaff, W. D., Christman, G. M., Coutifaris, C., Taylor, H. S., Eisenberg, E., et al. (2012) · Contemporary Clinical Trials · doi:10.1016/j.cct.2011.12.005 · Cited by 65
“(2001) [14] Open label letrozole only N=12 (PCOS)”
BackgroundFouda, U. M., & Sayed, A. M. (2011) · Reproductive Biology and Endocrinology · doi:10.1186/1477-7827-9-84 · Cited by 64
“The results of our study are in agree with the results of Metwally and Casper and Sh Tehrani-Nejad et al [20,27].”
BackgroundResultInfluentialÖner, G., Özçelik, B., Özgün, M. T., Serin, İ. S., Öztürk, F., & Başbuğ, M. (2010) · Human Reproduction · doi:10.1093/humrep/deq016 · Cited by 66
“It has been reported that infertile women are 6–8 times more likely than fertile women to have the disease (Mitwally and Casper, 2001).”
Background
Metadata
- Authors
- Mitwally, M. F. M., & Casper, R. F.
- Affiliations
- Mount Sinai Hospital (CA)
- University of Toronto (CA)
- Corresponding author
- Casper, Robert F
- ORCID
- Casper, Robert F
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2001-02
- Volume
- 75
- Issue
- 2
- Pages
- 305-309
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2165232862
- Cited by
- 800
- References
- 45
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 13 · 2023: 20 · 2022: 28 · 2021: 26 · 2020: 23 · 2019: 22 · 2018: 25 · 2017: 56 · 2016: 24 · 2015: 69 · 2014: 49 · 2013: 52 · 2012: 63
- FWCI
- 14.93
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Biology and Fertility
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Keywords
- letrozole, aromatase inhibitors, ovulation induction, polycystic ovary syndrome, ovulatory infertility, anovulatory infertility, endometrial thickness, pregnancy rate, follicle recruitment
- MeSH terms
- Letrozole, Anovulation, Endometrium, Enzyme Inhibitors, Estradiol, Female, Chorionic Gonadotropin, Humans, Infertility, Female, Luteinizing Hormone, Nitriles, Ovulation Induction, Polycystic Ovary Syndrome, Pregnancy, Prospective Studies, Triazoles, Aromatase Inhibitors
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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