Sequential use of letrozole and gonadotrophin in women with poor ovarian reserve: a randomized controlled trial

REPRODUCTIVE BIOMEDICINE ONLINE

卷:23

Article

Lee, Vivian Chi Yan¹  Chan, Carina Chi Wai¹  Ng, Ernest Hung Yu¹  Yeung, William Shu Biu¹  Ho, Pak Chung¹ 

[1] Univ Hong Kong, Dept Obstet & Gynecol, Queen Mary Hosp, Hong Kong, Hong Kong, Peoples R China

关键词: follicular fluid;    IVF;    letrozole;    live-birth rate;    poor ovarian responders;   

DOI  :  10.1016/j.rbmo.2011.05.012

来源: Elsevier

【 摘 要 】

Sequential use of letrozole and human menopausal gonadotrophin (HMG) was compared with HMG only in poor ovarian responders undergoing IVF. Patients (n = 53) with less than four oocytes retrieved in previous IVF cycles or less than five antral follicles were randomized to either letrozole for 5 days followed by HMG or HMG alone. The letrozole group had lower dosage of HMG (P < 0.001), shorter duration of HMG (P < 0.001) and fewer oocytes (P = 0.001) when compared with controls. Live-birth rate was comparable with a lower miscarriage rate in the letrozole group (P = 0.038). Serum FSH concentrations were comparable in both groups except on day 8, while oestradiol concentrations were all lower in the letrozole group from day 4 (all P < 0.001). Follicular fluid concentrations of testosterone, androstenedione, FSH and anti-Mullerian hormone were higher in the letrozole group (P = 0.009, P = 0.001, P = 0.046 and P = 0.034, respectively). Compared with HMG alone, sequential use of letrozole and HMG in poor responders resulted in significantly lower total dosage and shorter duration of HMG, a comparable live-birth rate, a significantly lower miscarriage rate and a more favourable hormonal environment of follicular fluid. (C) 2011, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

【 授权许可】

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