Comparison of Combined Letrozole and Clomiphene Citrate With Gonadotropin Microstimulation Protocols on Fertility Outcomes.

IF 3.6 4区医学 Q2 PHARMACOLOGY & PHARMACY

Clinical therapeutics Pub Date : 2025-08-27 DOI:10.1016/j.clinthera.2025.07.025

Na Zhou, Jiao Xu, Ling Liu, Yichen Yang, Xuejiao Fan, Haiqin Ren

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Abstract

Purpose: Large-scale data comparing the effects of combined letrozole (LE) and clomiphene citrate (CC) with gonadotropin (Gn) microstimulation protocols on pregnancy outcomes are lacking. This study aimed to compare the effects of CC + Gn and LE + Gn microstimulation protocols on fertility outcomes.

Methods: A retrospective cohort study was conducted to include infertile patients between January 1, 2018, and December 31, 2022. All patients underwent a microstimulation protocol and treatment was administered using either CC + Gn or LE + Gn. The main study outcomes included clinical pregnancy, miscarriage, and live birth rates.

Findings: Of the 1697 included patients, 875 were treated with CC + Gn, while the remaining 822 were treated with LE + Gn. We noted that CC + Gn was associated with a lower clinical pregnancy rate (odds ratio (OR): 0.324; 95% confidence interval (CI): 0.127-0.829; P = 0.019) and live birth rate (OR: 0.332; 95% CI: 0.112-0.988; P = 0.048) than LE + Gn; however, there was no significant difference between CC + Gn and LE + Gn regarding the abortion rate (OR: 0.523; 95% CI: 0.028-9.720; P = 0.664). Moreover, there were significant differences between the CC + Gn and LE + Gn groups in the number of embryos transferred (P < 0.001), number of frozen embryos (P < 0.001), and number of embryos at the frozen cleavage stage (P = 0.002).

Implications: LE + Gn microstimulation protocol was associated with better fertility outcomes than CC + Gn in terms of clinical pregnancy and live birth rates in patients with infertility.

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来曲唑与枸橼酸克罗米芬联合应用与促性腺激素微刺激方案对生育结果的比较。

目的：比较来曲唑（LE）和枸橼酸克罗米芬（CC）联合使用促性腺激素（Gn）微刺激方案对妊娠结局影响的大规模数据缺乏。本研究旨在比较CC + Gn和LE + Gn微刺激方案对生育结果的影响。方法：回顾性队列研究纳入2018年1月1日至2022年12月31日期间的不孕症患者。所有患者均接受微刺激方案，并使用CC + Gn或LE + Gn进行治疗。主要研究结果包括临床妊娠、流产和活产率。结果：在纳入的1697例患者中，875例接受CC + Gn治疗，其余822例接受LE + Gn治疗。我们注意到CC + Gn与较低的临床妊娠率相关(优势比（OR）： 0.324；95%置信区间（CI）： 0.127-0.829；P = 0.019)和活产率（OR: 0.332; 95% CI: 0.112-0.988; P = 0.048）优于LE + Gn；CC + Gn与LE + Gn流产率差异无统计学意义（OR: 0.523; 95% CI: 0.028 ~ 9.720; P = 0.664）。CC + Gn组和LE + Gn组在移植胚胎数（P < 0.001）、冷冻胚胎数（P < 0.001）和冷冻卵裂期胚胎数（P = 0.002）方面均有显著差异。意义：LE + Gn微刺激方案在不孕患者的临床妊娠和活产率方面比CC + Gn有更好的生育结果。

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

Clinical therapeutics 医学-药学

CiteScore

6.00

自引率

3.10%

发文量

154

审稿时长

9 weeks

期刊介绍： Clinical Therapeutics provides peer-reviewed, rapid publication of recent developments in drug and other therapies as well as in diagnostics, pharmacoeconomics, health policy, treatment outcomes, and innovations in drug and biologics research. In addition Clinical Therapeutics features updates on specific topics collated by expert Topic Editors. Clinical Therapeutics is read by a large international audience of scientists and clinicians in a variety of research, academic, and clinical practice settings. Articles are indexed by all major biomedical abstracting databases.