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Letrozole in fertility

Shayesteh Mehdinejadiani, Fardin Amidi, Mehdi Mehdizadeh, Mahmood Barati, Leili Safdarian, Reza Aflatoonian, Ashraf Alyasin, Marzieh Aghahosseini, Azar Pazhohan, Parisa Hayat, Farzaneh Mohammadzadeh Kazorgah, Aligholi Sobhani
Polycystic ovarian syndrome (PCOS) is a common endocrinologic disorder in women of reproductive age characterized by polycystic ovaries, oligo/anovulation, and hyperandrogenism. Not only anovulation but also endometrial dysfunction can reduce fertility in PCOS patients. Wnt pathway is responsible for endometrial proliferation which be strongly regulated by estradiol. To determine the effects of clomiphene citrate (CC) and letrozole, we measured the expression of some main ligands of Wnt/β-catenin signaling including Wnt7a, Wnt3, and Wnt8b in the endometrial samples taken from PCOS women on day 12 of the menses who received 100 mg CC or 5 mg letrozole as well as from women without treatment...
March 6, 2018: Gynecological Endocrinology
Shirley Shue, Milena Radeva, Tommaso Falcone
STUDY OBJECTIVE: To determine if the number of fibroids removed during myomectomy for symptomatic relief affects long-term fertility outcomes in reproductive aged women. DESIGN: Retrospective cohort survey study (Canadian Task Force classification II-2) SETTING: University hospital PATIENTS: One hundred forty-four patients who underwent myomectomy for symptomatic fibroids and attempted to conceive afterwards INTERVENTION: Questionnaire mailed to reproductive-aged women who received robotic, laparoscopic, or abdominal myomectomy MEASUREMENTS AND MAIN RESULTS: Patients with >6 fibroids removed were less likely to achieve pregnancy after myomectomy than patients with ≤6 fibroids removed (22...
January 22, 2018: Journal of Minimally Invasive Gynecology
L Del Pup, F A Peccatori
Very high progesterone levels (mean 186.6 ± 43.6 ng/mL) during the luteal phase were found in a small study of breast cancers patients undergoing controlled ovarian stimulation (COS) with letrozole plus recombinant FSH. Results highlight the need to further evaluate this in larger series. While waiting, the clinical significance of high progesterone levels can be drawn from epidemiological and experimental data here reviewed in order to give reassurance to the clinician involved in fertility preservation. If the progesterone increase will be confirmed, epidemiological and experimental data do not seem to indicate a detrimental effect or they could even be protective...
January 2018: European Review for Medical and Pharmacological Sciences
Mohamed Abdel-Fattah Youssef, Madelon van Wely, Monique Mochtar, Usama Mohamed Fouda, Ashraf Eldaly, Eman Zein El Abidin, Ahmed Elhalwagy, Ahmed Abdel Mageed Abdallah, Sherif Sameh Zaki, Mohamed Sayed Abdel Ghafar, Mohamed Nagi Mohesen, Fulco van der Veen
OBJECTIVE: To evaluate the effectiveness of low doses of gonadotropins and gonadotropins combined with oral compounds compared with high doses of gonadotropins in ovarian stimulation regimens in terms of ongoing pregnancy per fresh IVF attempt in women with poor ovarian reserve undergoing IVF/intracytoplasmic sperm injection (ICSI) treatment. DESIGN: A systematic review and meta-analysis of randomized controlled studies that evaluate the effectiveness of low dosing of gonadotropins alone or combined with oral compounds compared with high doses of gonadotropins in women with poor ovarian reserve undergoing IVF/ICSI treatment...
January 6, 2018: Fertility and Sterility
Ludmila Bercaire, Sara Mb Nogueira, Priscila Cm Lima, Vanessa R Alves, Nilka Donadio, Artur Dzik, Mario Cavagna, Renato Fanchin
OBJECTIVE: This study aimed to assess a novel protocol designed to improve poor ovarian response through intra-ovarian androgenization. The endpoints were: number of oocytes and mature oocytes retrieved, fertilization, cancellation and pregnancy rates. METHODS: This prospective crossover study enrolled poor responders from previous ovarian stimulation cycles submitted to a novel protocol called ANDRO-IVF. The protocol included pretreatment with transdermal AndroGel(r) (Besins) 25 mg, oral letrozole 2...
January 5, 2018: JBRA Assisted Reproduction
Cynthia M Farquhar, Emily Liu, Sarah Armstrong, Nicola Arroll, Sarah Lensen, Julie Brown
BACKGROUND: Women with unexplained infertility are often offered intrauterine insemination (IUI) with ovarian stimulation as an alternative to in-vitro fertilisation (IVF). However, little evidence exists that IUI is an effective treatment. In 2013, the UK National Institute for Health and Care Excellence recommended that IUI should not be routinely offered for couples with unexplained infertility. METHODS: For this pragmatic, open-label, randomised, controlled, two-centre study, we enrolled women attending two fertility clinics in New Zealand with unexplained infertility and an unfavourable prognosis of natural conception...
February 3, 2018: Lancet
Sam Lepine, Junyoung Jo, Mostafa Metwally, Ying C Cheong
BACKGROUND: Polycystic ovary syndrome (PCOS) is a common endocrine condition, affecting approximately one in 10 women. PCOS is defined by two of three features: oligo- or anovulation, clinical or biochemical hyperandrogenism or both, or polycystic ovaries.Women with PCOS can have a wide range of health problems, including infrequent and irregular periods, unwanted hair growth and acne, and subnormal fertility. Long-term health concerns include an increased risk of heart disease, diabetes and the development of precancerous disease of the womb...
November 10, 2017: Cochrane Database of Systematic Reviews
Mohan S Kamath, Abha Maheshwari, Siladitya Bhattacharya, Kar Yee Lor, Ahmed Gibreel
BACKGROUND: Gonadotropins are the most commonly used medications for controlled ovarian stimulation in in vitro fertilisation (IVF). However, they are expensive and invasive, and are associated with the risk of ovarian hyperstimulation syndrome (OHSS). Recent calls for more patient-friendly regimens have led to growing interest in the use of clomiphene citrate (CC) and aromatase inhibitors with or without gonadotropins to reduce the burden of hormonal injections. It is currently unknown whether regimens using CC or aromatase inhibitors such as letrozole (Ltz) are as effective as gonadotropins alone...
November 2, 2017: Cochrane Database of Systematic Reviews
Evan Taerk, Edward Hughes, Cassandra Greenberg, Michael Neal, Shilpa Amin, Mehrnoosh Faghih, Megan Karnis
BACKGROUND: The purpose of this study was to evaluate whether clinical pregnancy rate is affected by timing intrauterine insemination (IUI) according to serum LH surge, r-hCG trigger, or a combination of LH surge and r-hCG trigger in controlled ovarian hyperstimulation (COH) cycles for patients with a variety of infertility etiologies. METHODS: The last 365 consecutive COH-IUI cycles performed at ONE Fertility Burlington in 2014 were reviewed and categorized according to method of IUI timing...
July 2017: Journal of Reproduction & Infertility
H Adeldust, A Farzinpour, A Farshad, J Rostamzadeh, M Lopez-Bejar
Rooster fertility peaks between 30 and 40 weeks of age and declines rapidly from 50 weeks of age. This is linked to a reduction in the number of spermatozoa in the ejaculate due to high density of spermatids in the seminiferous tubules of low-fertility roosters. In this study, we assessed the effects over spermatogenesis of both letrozole, an aromatase inhibitor, and a commercial herbal extract designed for improving fertility composed by Tribulus, Cinnamomum, Zingiber and Sativus. Forty-two-week-old Ross 308 roosters (n = 24) were distributed into four groups: control, letrozole (0...
October 2017: Reproduction in Domestic Animals, Zuchthygiene
Jigal Haas, Robert F Casper
There has been increasing interest in combining the oral agents clomiphene citrate (CC) and letrozole with gonadotropins in IVF: for poor responders to reduce the amount of gonadotropins used, and in normal responders to reduce the incidence of ovarian hyperstimulation (OHSS). In normal responders, mild stimulation with the use of CC and gonadotropins was found to decrease the number of oocytes retrieved and result in good pregnancy rates, but in most studies the cumulative pregnancy rate was lower compared with conventional ovarian stimulation when frozen embryo transfers were considered...
October 2017: Fertility and Sterility
N Halászová, I Crha, M Huser, V Weinberger, J Žáková, M Ješeta, E Lousová, E Filipinská, P Ventruba
OBJECTIVE: To present current options and own experiences with ovarian stimulation in young women with breast cancer before gonadotoxic therapy. DESIGN: Review article with own experiencies. METHODS: Literary search, analysis of own experiences with complex therapy in women with breast cancer planning pregnancy, definitions of stimulating protocols, using methods of assisted reproduction. SETTING: Department of Obstetrics and Gynecology, Faculty of Medicine, Masaryk University and University Hospital Brno...
2017: Ceská Gynekologie
M J Yapura, E M Zwiefelhofer, R A Pierson, G P Adams
Numerous treatments and protocols have been used to control the reproductive cycle in cattle, with varying effectiveness and many involving the administration of steroid hormones. Steroid hormones, such as estradiol, are perceived as having a negative impact on consumer health. This internationally shared opinion has led to a ban on the use of steroid hormones in food producing animals in many countries (i.e., European Union, New Zealand, and Australia). Letrozole, a non-steroidal aromatase inhibitor, inactivates the aromatase enzyme responsible for the synthesis of estrogens by reversibly binding to the "heme" group of the P450 subunit...
September 11, 2017: Theriogenology
Christopher N Herndon, Yanett Anaya, Martha Noel, Hakan Cakmak, Marcelle I Cedars
OBJECTIVE: To report on outcomes from a university-based low-cost and low-complexity IVF program using mild stimulation approaches and simplified protocols to provide basic access to ART to a socioculturally diverse low-income urban population. DESIGN: Retrospective cohort study. SETTING: Academic infertility center. PATIENT(S): Sixty-five infertile couples were enrolled from a county hospital serving a low-resource largely immigrant population...
October 2017: Fertility and Sterility
Volkan Turan, Giuliano Bedoschi, Volkan Emirdar, Fred Moy, Kutluk Oktay
BACKGROUND: Aromatase inhibitors (AI) have been introduced to reduce estrogen exposure in women with estrogen-sensitive cancer undergoing ovarian stimulation for oocyte/embryo cryopreservation. There have been questions regarding whether the addition of AI and the presence of BRCA mutations affect cycle outcomes. We sought to determine the impact of letrozole and BRCA mutations on fertility preservation (FP) cycle outcomes of patients undergoing ovarian stimulation with an antagonist protocol...
January 2018: Reproductive Sciences
Nigel Pereira, Amelia G Kelly, Logan D Stone, Justine D Witzke, Jovana P Lekovich, Rony T Elias, Glenn L Schattman, Zev Rosenwaks
OBJECTIVE: To compare the oocyte and embryo yield associated with GnRH-agonist triggers vs. hCG triggers in cancer patients undergoing controlled ovarian stimulation (COS) for fertilization preservation. DESIGN: Retrospective cohort study. SETTING: Academic center. PATIENT(S): Cancer patients undergoing COS with letrozole and gonadotropins or gonadotropin-only protocols for oocyte or embryo cryopreservation. INTERVENTION(S): Gonadotropin-releasing hormone agonist or hCG trigger...
September 2017: Fertility and Sterility
S A Amer, J Smith, A Mahran, P Fox, A Fakis
STUDY QUESTION: Would letrozole as a primary ovulation induction agent generate better pregnancy rates than clomiphene citrate (CC) in subfertile women with anovulatory polycystic ovarian syndrome (PCOS)? SUMMARY ANSWER: Participants receiving letrozole as a primary treatment achieved a significantly (P = 0.022) higher clinical pregnancy rate per patient (61.2%) compared to CC (43.0%). WHAT IS KNOWN ALREADY: According to a recent Cochrane systematic review (2014), letrozole appears to improve live-birth (LB) and pregnancy rates in anovulatory women with PCOS, compared to CC...
August 1, 2017: Human Reproduction
T Dahhan, E M E Balkenende, C C M Beerendonk, K Fleischer, D Stoop, A M E Bos, C B Lambalk, R Schats, R J T van Golde, I Schipper, L A Louwé, A E P Cantineau, J M J Smeenk, J P de Bruin, N Reddy, Y Kopeika, F van der Veen, M van Wely, S C Linn, M Goddijn
BACKGROUND: Chemotherapy for breast cancer may have a negative impact on reproductive function due to gonadotoxicity. Fertility preservation via banking of oocytes or embryos after ovarian stimulation with FSH can increase the likelihood of a future live birth. It has been hypothesized that elevated serum estrogen levels during ovarian stimulation may induce breast tumour growth. This has led to the use of alternative stimulation protocols with addition of tamoxifen or letrozole. The effectiveness of these stimulation protocols in terms of oocyte yield is unknown...
July 11, 2017: Contemporary Clinical Trials
Sung Woo Kim, Hoon Kim, Seung-Yup Ku, Chang Suk Suh, Seok Hyun Kim, Young Min Choi
Estrogen-dependent early stage endometrial cancer is relatively common in young women of reproductive age. The standard treatment is hysterectomy and bilateral salpingo-oophorectomy (BSO), even in early stage well-differentiated endometrial cancer patients. This surgical option results in permanent loss of fertility. There have been some reports of live births using in vitro fertilization after conservative management of endometrial cancer with high-dose progestin for the purpose of fertility preservation. However, most were not recurrent cases and pregnancy was achieved through conventional in vitro fertilization, which usually raises serum estradiol levels and may lead to the recurrence of endometrial cancer...
June 26, 2017: Gynecological Endocrinology
Nigel Pereira, Andrea G Hubschmann, Jovana P Lekovich, Glenn L Schattman, Zev Rosenwaks
OBJECTIVE: To report a case of ex vivo oocyte retrieval from oophorectomized specimens in a BRCA1 mutation carrier undergoing surgical staging for ovarian cancer. DESIGN: Video case report and literature review. SETTING: University-affiliated center. PATIENT(S): A 37-year-old single woman, gravida 0, with a known BRCA1 mutation, presented to her oncologist with a complex right ovarian mass and elevated CA-125 level...
August 2017: Fertility and Sterility
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