New advances in ovulation induction
Abstract
PURPOSE OF REVIEW: To review recent advances in ovulation induction. RECENT FINDINGS: Aromatase inhibitors can replace clomiphene citrate as ovulation-inducing substances. The most widely used aromatase inhibitor for this purpose is letrozole and the optimal dose is 5 mg daily for 5 days. Compared to clomiphene citrate, it is associated with a thicker endometrium and a better pregnancy rate. It is as effective as gonadotropin but yet less expensive. The overall rates of congenital malformation among newborns conceived after infertility treatment with letrozole or clomiphene citrate are similar. When letrozole is combined with gonadotropin, it leads to lower gonadotropin requirements with pregnancy rates comparable to gonadotropin treatment alone. Another promising aromatase inhibitor is anastrazole. Recent evidence suggests that luteinizing hormone activity in human menopausal gonadotropin modifies follicular development so that fewer intermediate-sized follicles develop. Compared to the use of follicular stimulating hormone only, human menopausal gonadotropin is associated with less ovarian hyperstimulation. SUMMARY: Aromatase inhibitors are alternative drugs to clomiphene or gonadotropin for ovulation induction or superovulation.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
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?
The incidence of ovarian hyperstimulation syndrome with clomiphene citrate is less than 1%.
“The incidence of ovarian hyperstimulation syndrome is less than 1%. 219”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [219]
The rates of twin and triplet pregnancy with clomiphene citrate are 5%-7% and 0.3%, respectively.
“The rates of twin and triplet pregnancy with clomiphene citrate are 5%-7% and 0.3%, respectively.”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [219]
Cites
Mitwally, M. F. M., & Casper, R. F. (2001) · Fertility and Sterility · doi:10.1016/s0015-0282(00)01705-2 · Cited by 801 · see citing works
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 · see citing works
Self-citationSammour, A., Biljan, M. M., Tan, S. L., & Tulandi, T. (2001) · Fertility and Sterility · doi:10.1016/s0015-0282(01)02323-8 · Cited by 238 · see citing works
Self-citationThe Outcome of 150 Babies Following the Treatment With Letrozole or Letrozole and Gonadotropins
Biljan, M. M., Hemmings, R., & Brassard, N. (2005) · Fertility and Sterility · doi:10.1016/j.fertnstert.2005.07.230 · Cited by 206 · see citing works
A 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 · see citing works
Self-citationPregnancy 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 · see citing works
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 · see citing works
A 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 · see citing works
Self-citationLaparoscopic treatment of polycystic ovaries with insulated needle cautery: a reappraisal
Felemban, A., Tan, S. L., & Tulandi, T. (2000) · Fertility and Sterility · doi:10.1016/s0015-0282(99)00534-8 · Cited by 154 · see citing works
Self-citationHealey, S., Tan, S. L., Tulandi, T., & Biljan, M. M. (2003) · Fertility and Sterility · doi:10.1016/j.fertnstert.2003.03.001 · Cited by 132 · see citing works
Self-citationComparison of tamoxifen and clomiphene citrate for ovulation induction: a meta-analysis
Steiner, A. Z., Terplan, M., & Paulson, R. J. (2005) · Human Reproduction · doi:10.1093/humrep/deh840 · Cited by 122 · see citing works
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 · see citing works
Sohrabvand, F., Ansari, S., & Bagheri, M. (2006) · Human Reproduction · doi:10.1093/humrep/del020 · Cited by 97 · see citing works
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 · see citing works
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 · see citing works
Self-citationPlatteau, P., Andersen, A. N., Balen, A. H., Devroey, P., Sørensen, P. S., Helmgaard, L., & Arce, J. (2006) · Human Reproduction · doi:10.1093/humrep/del085 · Cited by 81 · see citing works
Elnashar, A. M., Abdelmageed, E., Fayed, M. R., & Sharaf, M. (2006) · Human Reproduction · doi:10.1093/humrep/del053 · Cited by 80 · see citing works
Elnashar, A. M., Fouad, H., Eldosoky, M., & Saeid, N. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2005.08.016 · Cited by 67 · see citing works
Jee, B. C., Ku, S., Suh, C. S., Kim, K. C., Lee, W. D., & Kim, S. H. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2006.02.070 · Cited by 57 · see citing works
Saleh, A., & Khalil, H. S. (2004) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/j.0001-6349.2004.00481.x · Cited by 52 · see citing works
Biljan, M. M., Tan, S. L., & Tulandi, T. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(02)03524-0 · Cited by 23 · see citing works
Self-citationNardo, L. G. (2004) · Gynecological Endocrinology · doi:10.1080/09513590400015526 · Cited by 21 · see citing works
Zhu, W., Li, X., Chen, X., Lin, Z., & Zhang, L. (2006) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2006.01.022 · Cited by 14 · see citing works
Palomba, S., Falbo, A. I., Orio, F., Russo, T., Sbano, F. M., D’Alessandro, P., Cariati, F., Tolino, A., Colao, A., & Zullo, F. (2006) · Gynecological Endocrinology · doi:10.1080/09513590600645700 · Cited by 13 · see citing works
Tamoxifen citrate for women with unexplained infertility
Shokeir, T. A. (2006) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-006-0181-8 · Cited by 5 · see citing works
Nestler, J. E. (2006) · Nature Clinical Practice Endocrinology & Metabolism · doi:10.1038/ncpendmet0113 · Cited by 5 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Infertility and the provision of infertility medical services in developing countries
Ombelet, W., Cooke, I., Dyer, S., Serour, G., & Devroey, P. (2008) · Human Reproduction Update · doi:10.1093/humupd/dmn042 · Cited by 720 · see citing works
Assessment 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 · see citing works
Estrogen receptors as therapeutic targets in breast cancer.
Ariazi, E. A., Ariazi, J. L., Cordera, F., & Jordan, V. (2006) · Current Topics in Medicinal Chemistry · doi:10.1002/9783527623297.ch5 · Cited by 303 · see citing works
Neven, A., Laven, J., Teede, H., & Boyle, J. (2018) · Seminars in Reproductive Medicine · doi:10.1055/s-0038-1668085 · Cited by 196 · see citing works
Polycystic ovarian syndrome-current pharmacotherapy and clinical implications
Rashid, R., Mir, S. A., Kareem, O., Ali, T. F., Ara, R., Malik, A., Amin, F., & Bader, G. N. (2022) · Taiwanese Journal of Obstetrics and Gynecology · doi:10.1016/j.tjog.2021.11.009 · Cited by 157 · see citing works
Infertility 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 · see citing works
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 125 · see citing works
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 · see citing works
The 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 · see citing works
Recent progress in luteinizing hormone/human chorionic gonadotrophin hormone research
Rahman, N. A., & Rao, C. V. (2009) · Molecular Human Reproduction · doi:10.1093/molehr/gap067 · Cited by 50 · see citing works
Mvondo, M. A., Tsoplfack, F. I. M., Awounfack, C. F., & Njamen, D. (2020) · BMC Complementary Medicine and Therapies · doi:10.1186/s12906-020-03070-8 · Cited by 44 · see citing works
Status of clomiphene citrate and metformin for infertility in PCOS
Misso, M. L., Teede, H. J., Hart, R. J., Wong, J., Rombauts, L. J. F., Melder, A., Norman, R. J., & Costello, M. (2012) · Trends in Endocrinology and Metabolism · doi:10.1016/j.tem.2012.07.001 · Cited by 36 · see citing works
Costello, M., Garad, R. M., Hart, R. J., Homer, H. A., Johnson, L., Jordan, C., Mocanu, E. V., Qiao, J., Rombauts, L. J. F., Teede, H. J., et al. (2019) · Medical Sciences · doi:10.3390/medsci7090095 · Cited by 32 · see citing works
Ovulation Induction in Polycystic Ovary Syndrome
Vause, T. D. R., Cheung, A. P., Sierra, S., Claman, P., Graham, J., Guillemin, J., Lapensée, L., Steward, S., Vause, T. D. R., & Wong, B. C.-M. (2010) · International Journal of Gynecology & Obstetrics · doi:10.1016/j.ijgo.2010.07.001 · Cited by 28 · see citing works
Waghmare, S. V., & Shanoo, A. (2023) · Cureus · doi:10.7759/cureus.47408 · Cited by 23 · see citing works
See, C., McCulloch, M., Smikle, C. B., & Gao, J. H. (2011) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2010.0254 · Cited by 17 · see citing works
Tredway, D. R., Schertz, J. C., Bock, D., Hemsey, G., & Diamond, M. P. (2011) · Fertility and Sterility · doi:10.1016/j.fertnstert.2010.11.068 · Cited by 14 · see citing works
Fatum, M., McVeigh, E., & Child, T. J. (2013) · Human Fertility · doi:10.3109/14647273.2013.800650 · Cited by 14 · see citing works
No. 362-Ovulation Induction in Polycystic Ovary Syndrome
Smithson, D. S., Vause, T. D. R., & Cheung, A. P. (2018) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/j.jogc.2017.12.004 · Cited by 14 · see citing works
Costello, M., & Ledger, W. J. (2012) · Women s Health · doi:10.2217/whe.12.14 · Cited by 13 · see citing works
Nahuis, M. J., Weiss, N. S., van der Veen, F., Mol, B. W., Hompes, P. G. A., Oosterhuis, J., Lambalk, C. B., Smeenk, J. M. J., Koks, C. A. M., van Golde, R. J. T., et al. (2013) · BMC Women s Health · doi:10.1186/1472-6874-13-42 · Cited by 12 · see citing works
Eine interdisziplinäre Herausforderung
Segerer, S. E., Janssen, O. E., & Keck, C. (2014) · gynäkologie + geburtshilfe · doi:10.1007/s15013-013-0209-7 · Cited by 8 · see citing works
Aromatase over expression transgenic murine models for aromatase inhibitor studies
Li, X. (2009) · Molecular Human Reproduction · doi:10.1093/molehr/gap070 · Cited by 6 · see citing works
Abduljabbar, H. S., Hagras, M. M., & Magadmy, R. (2020) · IntechOpen eBooks · doi:10.5772/intechopen.90270 · Cited by 5 · see citing works
Xu, Y., Wang, E., Liu, T., Wang, S., Wu, F., Zhao, X., & Wang, A. (2023) · Journal of obstetrics and gynaecology research · doi:10.1111/jog.15747 · Cited by 4 · see citing works
Lozano, D. H. M., Lenero, M. V., Gonzalez, R. L., Scheffer, J. B., González, M., Barron, Y., & Frydman, R. (2015) · PubMed Central · Cited by 4 · see citing works
Eli, D. M., Chukwuebuk, N., Yabrade, T. P.-E., Ehebha, S. E., Richard, O., Olowe, G. T., Chukwu, O., Ebuwa, E. I., & Peter, A. C. (2022) · Pakistan Journal of Biological Sciences · doi:10.3923/pjbs.2022.1066.1076 · Cited by 3 · see citing works
Ovulasjonsinduksjon ved bruk av letrozol
Ekerhovd, E. (2009) · Tidsskrift for Den norske legeforening · doi:10.4045/tidsskr.08.0129 · Cited by 3 · see citing works
Infertility in women with polycystic ovary syndrome and the role of metformin in management
Boyle, J. A., Teede, H. J., & Misso, M. L. (2013) · Expert Review of Obstetrics & Gynecology · doi:10.1586/17474108.2013.842689 · Cited by 2 · see citing works
The use of aromatase inhibitors in infertility and gynecology
Al-Shalati, J., & Tulandi, T. (2011) · Expert Review of Obstetrics & Gynecology · doi:10.1586/eog.11.30 · Cited by 2 · see citing works
Self-citationThe patient with polycystic ovary syndrome
Norman, R. J., & Lim, S. S. (2008) · Reproductive medicine and assisted reproductive techniques series · doi:10.3109/9780203092200.012 · Cited by 2 · see citing works
No 362 - Déclenchement de l'ovulation en présence d'un syndrome des ovaires polykystiques
Smithson, D. S., Vause, T. D. R., & Cheung, A. P. (2018) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/j.jogc.2018.05.013 · Cited by 1 · see citing works
Permadi, I. G. N. W., & Prasetyaji, I. W. (2025) · Majalah Obstetri & Ginekologi · doi:10.20473/mog.v33i12025.44-52 · Cited by 1 · see citing works
Assisted Reproduction and Discussion of Rare Cases in Monozygotic Twinning
Tan, Y. (2023) · Twin Research and Human Genetics · doi:10.1017/thg.2023.22 · Cited by 1 · see citing works
Déclenchement de l'ovulation en présence du syndrome des ovaires polykystiques
Vause, T. D. R., Cheung, A. P., Cheung, A. P., Sierra, S., Claman, P., Graham, J., Guillemin, J.-A., Lapensée, L., Stewart, S., Vause, T. D. R., et al. (2010) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/s1701-2163(16)34505-4 · Cited by 1 · see citing works
Shrivastava, D., Gupta, M., Samal, S., Bagde, N., Mishra, N. K., & Gupta, S. (2017) · Journal of Datta Meghe Institute of Medical Sciences University · doi:10.4103/jdmimsu.jdmimsu_14_17 · Cited by 1 · see citing works
Integrated Strategies for Enhancement of Fertility in PCOS
Coghlan, E., & Hart, R. J. (2018) · Springer eBooks · doi:10.1007/978-3-319-45534-1_21 · Cited by 1 · see citing works
Polycystic Ovary Syndrome: Fertility Treatment Options
Mintziori, G., Goulis, D. G., & Tarlatzis, B. C. (2021) · ISGE series · doi:10.1007/978-3-030-63650-0_10 · Cited by 1 · see citing works
„Off-label-Anwendung“ von Aromatasehemmern
Bohlmann, M. K., Hornemann, A., Weichert, J., Stichtenoth, G., Ortmann, J., Diedrich, K., & Lüdders, D. (2008) · Gynäkologische Endokrinologie · doi:10.1007/s10304-008-0265-6 · Cited by 1 · see citing works
The patient with polycystic ovary syndrome
Lim, S. S. (2008) · CRC Press eBooks · doi:10.3109/9780203092200-15
Letrozol zur Ovulationsinduktion bei PCOS
Doblinger, J., & Griesinger, G. (2017) · Gynäkologische Endokrinologie · doi:10.1007/s10304-017-0128-0
Déclenchement de l'ovulation en présence du syndrome des ovaires polykystiques Résumé
Vause, T. D. R., Cheung, A. P., Sierra, S., Claman, P., Graham, J., Guillemin, J., Lapensée, L., Stewart, S., Wong, B. C.-M., Société, C. D., et al. (2010)
Hellebaut, S., Meerschaut, F. V., & Vandekerckhove, F. (2020) · Tijdschrift voor Geneeskunde · doi:10.47671/tvg.76.20.039
Ovarian stimulation with clomiphene citrate
Peigné, M., Sonigo, C., & Robin, G. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-13825-6.00268-5
Management of Female Infertility
Tarlatzi, T. B., Dafopoulos, K. C., & Tarlatzis, B. C. (2026) · Springer eBooks · doi:10.1007/978-3-032-05381-7_17
Salles, L. C., Ribeiro, M. L. M. M., & Colodetti, L. (2021) · Femina · doi:10.61622/0100-72544910202109
Murawski, M., Góral, A., Miszczak, M. M., & Prescha, A. (2026) · Nutrients · doi:10.3390/nu18193218
- Authors
- Kafy, S., & Tulandi, T.
- Affiliations
- McGill University (CA)
- Corresponding author
- Tulandi, Togas
- Venue
- Current Opinion in Obstetrics & Gynecology
- Published
- 2007-06
- Volume
- 19
- Issue
- 3
- Pages
- 248-252
- ISSN
- 1040-872X (ISSN-L)
- OpenAlex
- W2062827277
- Cited by
- 47
- References
- 26
- Citations by year
- 2026: 2 · 2025: 2 · 2023: 3 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 1 · 2018: 5 · 2017: 2 · 2015: 1 · 2014: 1 · 2013: 3 · 2012: 3
- FWCI
- 4.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Obstetrics & Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
- Keywords
- ovulation induction, aromatase inhibitors, letrozole, clomiphene citrate, anastrozole, gonadotropins, human menopausal gonadotropin, superovulation, ovarian hyperstimulation, endometrial thickness, pregnancy rate, congenital malformations, infertility treatment
- MeSH terms
- Letrozole, Anastrozole, Clomiphene, Estrogen Antagonists, Female, Fertility Agents, Female, Gonadotropins, Humans, Infertility, Female, Nitriles, Ovary, Ovulation Induction, Pregnancy, Tamoxifen, Triazoles, Treatment Outcome, Pregnancy Rate, Aromatase Inhibitors
About these checks
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.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
