Cited by 372Reproductive Biology and FertilityOvarian function and disordersReproductive Health and Technologies

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A randomized single-blind controlled trial of letrozole as a low-cost IVF protocol in women with poor ovarian response: a preliminary report

Goswami, S.K.·2004·Human Reproduction

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Abstract

BACKGROUND: Use of letrozole, a selective inhibitor of aromatase, reduces the gonadotrophin dose required to induce follicular maturation. We evaluated whether incorporation of letrozole could be an effective low-cost IVF protocol for poor responders. METHODS: A randomized, controlled, single-blind trial was conducted in the Assisted Reproduction Unit, Institute of Reproductive Medicine, Kolkata, India. Thirty-eight women with a history of poor ovarian response to gonadotrophins were recruited. Thirteen women (Let-FSH group) received letrozole 2.5 mg daily from day 3-7, and recombinant FSH (rFSH) 75 IU/day on days 3 and 8; and 25 women (GnRH-ag-FSH group) underwent long GnRH agonist protocol and stimulated with rFSH (300-450 IU/day). Ovulation was triggered by 10,000 IU of HCG followed by IVF-embryo transfer. The main outcome measures were total dose of rFSH (IU/cycle), terminal estradiol (E2) (pg/ml), numbers of follicles, oocytes retrieved and transferable embryo, endometrial thickness (mm), and pregnancy rate. RESULTS: Compared with the GnRH-ag-FSH group (2865 +/- 228 IU), the Let-FSH group (150 +/- 0 IU) received a significantly (P < 0.001) lower total dose of FSH. Except for terminal E2, which was significantly higher (P < 0.001) in the GnRH-ag-FSH group (380 +/- 46 pg/ml) than the Let-FSH group (227 +/- 45 pg/ml), the treatment outcomes in all other respects, including pregnancy rate, were statistically comparable. CONCLUSIONS: Adjunctive use of letrozole may form an effective means of low-cost IVF protocol in poorly responding women.

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Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate
Mitwally, M. F. M., & Casper, R. F. (2001) · Fertility and Sterility · doi:10.1016/s0015-0282(00)01705-2 · Cited by 800 · cited 7×
“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).”
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Authors: Goswami, S. K.
Affiliations: Institute of Reproductive Medicine (IN)
Corresponding author: Goswami, S.K.
ORCID: Goswami, S.K.
Venue: Human Reproduction
Publisher: Oxford University Press (OUP)
Published: 2004-06-24
Volume: 19
Issue: 9
Pages: 2031-2035
ISSN: 0268-1161 (ISSN-L)
1460-2350
DOI: 10.1093/humrep/deh359
OpenAlex: W2105251513
Cited by: 372
References: 31
Citations by year: 2025: 5 · 2024: 3 · 2023: 6 · 2022: 8 · 2021: 12 · 2020: 14 · 2019: 10 · 2018: 5 · 2017: 40 · 2016: 12 · 2015: 44 · 2014: 37 · 2013: 33 · 2012: 36
FWCI: 8.53
Type: journal article
Language: en
Open access: closed
Locations: Human Reproduction (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Reproductive Medicine › Reproductive Biology and Fertility
Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
Keywords: letrozole, poor ovarian response, aromatase inhibitors, recombinant FSH, GnRH agonist protocol, oocyte retrieval, pregnancy rate
MeSH terms: Letrozole, Adult, Cost Control, Dose-Response Relationship, Drug, Drug Resistance, Embryo Transfer, Estradiol, Female, Fertilization in Vitro, Follicle Stimulating Hormone, Gonadotropins, Chorionic Gonadotropin, Humans, Gonadotropin-Releasing Hormone, Nitriles, Ovary, Pregnancy, Recombinant Proteins, Triazoles, Single-Blind Method, Treatment Outcome, Pregnancy Rate, Aromatase Inhibitors

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A randomized single-blind controlled trial of letrozole as a low-cost IVF protocol in women with poor ovarian response: a preliminary report

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