The Follicular Output Rate was Improved with 3-Day Letrozole Administration Compared with 5-Day Letrozole Administration Under Progestin-Primed Ovarian Stimulation.

IF 4.7 2区医学 Q1 CHEMISTRY, MEDICINAL

Drug Design, Development and Therapy Pub Date : 2025-05-27 eCollection Date: 2025-01-01 DOI:10.2147/DDDT.S521554

Xiaoning Wang, Jiarong Tian, Liu Tian, Xin Chen, Zhenzhen Zhang, Honglu Diao, Ying Zhang

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引用次数: 0

Abstract

Purpose: Progestin-primed ovarian stimulation (PPOS) has been widely employed in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles. In recent years, letrozole (LE) combined with medroxyprogesterone acetate (MPA) has been used in this protocol to enhance ovarian response. This study compared the effects of a 5-day regimen with those of a 3-day regimen of letrozole within PPOS, focused on the follicular output rate (FORT) and blastocyst formation rates.

Patients and methods: From January 2017 to January 2020, 1,754 infertility patients who received PPOS protocol were divided into two groups: 577 patients received 2.5 mg/day LE for 5 days (LE 5-day), and 1177 patients received the same dose of LE for 3 days (LE 3-day). Propensity score matching (1:1) balanced confounders, yielding 489 patients per group. The primary outcoms was the FORT. The rate of blastocyst formation was evaluated as the secondary outcome. A multivariable logistic regression analysis was performed to compare the disparity in the FORT between the two groups.

Results: After matching, the number of oocytes retrieved, number of mature oocytes, number of blastocysts, blastocyst formation rates, FORT, and clinical pregnancy rates were more favourable in the LE 3-day group than in the LE 5-day group (P < 0.05). In the multivariable linear regression model, after making adjustments for factors such as age, anti-Müllerian hormone (AMH), antral follicle count (AFC), body mass index (BMI), infertility type, and basal P, patients in the LE 3-day group exhibited an increase in the FOTR (β = 0.08, 95% confidence interval [CI] 0.02 to 0.14, P = 0.0082) and blastocyst formation rate (β = 0.23, 95% CI 0.17 to 0.29, P < 0.0001) compared to those in the LE 5-day group.

Conclusion: Compared with LE administration for 5 days, LE administration for 3 days may increase the FORT and the rate of blastocyst formation.

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在黄体酮刺激卵巢的情况下，来曲唑给药3天与来曲唑给药5天相比，卵泡排出率提高。

目的：孕激素刺激卵巢（PPOS）已广泛应用于体外受精/胞浆内单精子注射（IVF/ICSI）周期。近年来，来曲唑（LE）联合醋酸甲孕酮（MPA）用于该方案以增强卵巢反应。本研究比较了5天来曲唑治疗方案和3天来曲唑治疗方案对PPOS的影响，重点研究了卵泡排出率（FORT）和囊胚形成率。患者和方法：2017年1月至2020年1月，将1754例接受PPOS方案的不孕症患者分为两组：577例患者接受2.5 mg/天LE，持续5天（LE 5天），1177例患者接受相同剂量LE，持续3天（LE 3天）。倾向评分匹配（1:1）平衡混杂因素，每组产生489例患者。主要结果是FORT。评估囊胚形成率作为次要结果。采用多变量logistic回归分析比较两组间FORT的差异。结果：配型后，LE 3 d组取卵数、成熟卵数、囊胚数、囊胚形成率、FORT、临床妊娠率均优于LE 5 d组（P < 0.05）。在多变量线性回归模型中，在对年龄、抗勒氏激素（AMH）、窦卵泡计数（AFC）、体重指数（BMI）、不孕症类型和基础P等因素进行调整后，与LE 5天组相比，LE 3天组患者的FOTR （β = 0.08, 95%可信区间[CI] 0.02 ~ 0.14, P = 0.0082）和囊虫形成率（β = 0.23, 95% CI 0.17 ~ 0.29, P < 0.0001）均有所增加。结论：与5 d给药相比，3 d给药可提高FORT和囊胚形成率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drug Design, Development and Therapy CHEMISTRY, MEDICINAL-PHARMACOLOGY & PHARMACY

CiteScore

9.00

自引率

0.00%

发文量

382

审稿时长

>12 weeks

期刊介绍： Drug Design, Development and Therapy is an international, peer-reviewed, open access journal that spans the spectrum of drug design, discovery and development through to clinical applications. The journal is characterized by the rapid reporting of high-quality original research, reviews, expert opinions, commentary and clinical studies in all therapeutic areas. Specific topics covered by the journal include: Drug target identification and validation Phenotypic screening and target deconvolution Biochemical analyses of drug targets and their pathways New methods or relevant applications in molecular/drug design and computer-aided drug discovery* Design, synthesis, and biological evaluation of novel biologically active compounds (including diagnostics or chemical probes) Structural or molecular biological studies elucidating molecular recognition processes Fragment-based drug discovery Pharmaceutical/red biotechnology Isolation, structural characterization, (bio)synthesis, bioengineering and pharmacological evaluation of natural products** Distribution, pharmacokinetics and metabolic transformations of drugs or biologically active compounds in drug development Drug delivery and formulation (design and characterization of dosage forms, release mechanisms and in vivo testing) Preclinical development studies Translational animal models Mechanisms of action and signalling pathways Toxicology Gene therapy, cell therapy and immunotherapy Personalized medicine and pharmacogenomics Clinical drug evaluation Patient safety and sustained use of medicines.