The potential of letrozole use for priming in vitro maturation cycles

B I Rose, B I Rose

Abstract

Objective: To compare the pregnancy rates with two different methods of priming for in vitro maturation cycles (IVM). Cycles using letrozole together with hCG were compared to cycles using FSH together with hCG in 75 cycles in patients being treated for infertility by IVM.

Study design: Retrospective cohort non-inferiority trial Results: Using letrozole for priming was found to not be inferior to using FSH for priming cycles. The live birth rate per transfer was 31.6% in letrozole primed cycles compared to 20.8% in FSH primed cycles (not significant). However, FSH priming produced more oocytes that were mature on the day of retrieval (p = 0.004) and also resulted in more high quality embryos than did letrozole priming (p = 0.004).

Conclusion: Letrozole may be used for priming in IVM cycles in which the clinician views the characteristics of letrozole as more desirable than FSH.

Keywords: FSH priming; IVM; IVM priming; In vitro maturation; letrozole; letrozole priming.

References

    1. Begum MR, Ferdous J, Begum A, et al. Comparison of efficacy of aromatase inhibitor and clomiphene citrate in induction of ovulation in polycystic ovarian syndrome. Fertil Steril. 2009;92:853–857.
    1. Buckett WM, Chian R-C, Dean NL, et al. Pregnancy loss in pregnancies conceived after in vitro oocyte maturation, conventional in vitro fertilization, and intracytoplasmic sperm injection. Fertil Steril. 2008;90:546–550.
    1. Casper RF. Letrozole: ovulation or superovulation? Fertil Steril. 2003;80:1335–1337.
    1. Chian R, Uzelac PS, Nargund G. In vitro maturation of human immature oocytes for fertility preservation. Fertil Steril. 2013;99:1173–1181.
    1. Child TJ, Jalil AK, Gulekli B, et al. In vitro maturation and fertilization of oocytes from unstimulated normal ovaries, polycystic ovaries, and women with polycystic ovary syndrome. Fertil Steril. 2001;76:936–942.
    1. Cortinez A, De Carvalho I, Vantman D, et al. Hormonal profile and endometrial morphology in letrozole-controlled ovarian hyperstimulation in ovulatory infertile patients. Fertil Steril. 2005;83:110–115.
    1. Fadini R, Dal Canto MB, Renzini MM, et al. Effect of different gonadotropin priming on IVM of oocytes from women with normal ovaries: a prospective randomized study. Reprod BioMed Online. 2009;19:343–351.
    1. Gremeau A, Andreadis N, Fatum M, et al. In vitro maturation or in vitro fertilization for women with polycystic ovaries? A case-control study of 194 treatment cycles. Fertil Steril. 2012;98:355–360.
    1. Lewis V, Guzick DS. Clomiphene and intrauterine insemination (IUI)- What is the best way to time insemination? Fertil Steril. 2002;73:S154.
    1. Rose BI, Laky DC, Miller B. The case for IVM: Lower cost and more patient friendly. J Reprod Med. 2014
    1. Rose BI, Laky DC. A comparison of the Cook single lumen immature ovum IVM needle to the Steiner-Tan pseudo double lumen flushing needle for oocyte retrieval for IVM. J Assist Reprod Genet. 2013;30:855–860.
    1. Rotterdam ESHRE. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovarian syndrome (PCOS) Hum Reprod. 2004;19:41–47.
    1. Scott IA. Non-inferiority trials: determining whether alternative treatments are good enough. Med J Aust. 2009;190:326–330.
    1. Son W-Y, Tan SL. Laboratory and embryological aspects of hCG-primed in vitro maturation cycles for patients with polycystic ovaries. Hum Reprod Update. 2010;16:675–689.
    1. Wallace KL, Johnson V, Sopelak V, et al. Clomiphene citrate versus letrozole: molecular analysis of the endometrium in women with polycystic ovary syndrome. Fertil Steril. 2011;96:1051–1056.
    1. Wynn P, Picton HM, Krapez JA, et al. Pretreatment with follicle stimulating hormone promotes the numbers of human oocytes reaching metaphase II by in-vitro maturation. Hum Reprod. 1998;13:3132–3138.
    1. Young SL, Opsahl MS, Fritz MA. Serum concentrations of enclomiphene and zuclomiphene across consecutive cycles of clomiphene citrate therapy in anovulatory infertile women. Fertil Steril. 1999;71:639–644.

Source: PubMed

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