Letrozole co-treatment in infertile women 40 years old and older receiving controlled ovarian stimulation and intrauterine insemination.

Authors:

Mohamed A Bedaiwy Mahmoud Shokry Noha Mousa Anne Claessens Navid Esfandiari Lynda Gotleib Robert Casper

Fertil Steril 2009 Jun 23;91(6):2501-7. Epub 2008 May 23.

Toronto Centre For Advanced Reproductive Technologies (TCART), and Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.

Objective: To investigate the effect of a combination of letrozole and gonadotropins in advanced reproductive age infertile women who were treated with IUI.

Design: A retrospective case control study.

Setting: A private practice affiliated with an academic institute.

Patient(s): Infertile women 40 years old and older who were treated with IUI and controlled ovarian hyperstimulation (COH) using either letrozole in combination with FSH (n = 90) or FSH alone (n = 69).

Main Outcome Measure(s): Pregnancy rates (PR), mature follicles, serum levels of E(2), P, LH, endometrial thickness, rates of cycle cancellation, and FSH dose.

Result(s): Pregnancy rates were comparable between the letrozole-FSH co-treatment group and the FSH alone group. Significantly fewer cycles were cancelled in the letrozole co-treatment group. The E(2) levels and the number of follicles were significantly higher in the FSH-only group. Serum levels of LH were significantly higher in the co-treatment group on cycle day 7. The P levels were significantly higher in the FSH alone group on the day of hCG administration.

Conclusion(s): Letrozole co-treatment compared with using FSH alone has significantly modified the cycle characteristics without reducing PRs and could be of potential benefit in IUI cycles in older infertile women.