Rachel S. Mandelbaum M.D. , Ravi Agarwal M.D. , Samuel Melville M.D. , Caroline J. Violette M.D. , Sharon Winer M.D. , Donna Shoupe M.D. , Koji Matsuo M.D., Ph.D. , Richard J. Paulson M.D. , Molly M. Quinn M.D.
{"title":"来曲唑诱导多囊卵巢综合征妇女排卵的方案比较","authors":"Rachel S. Mandelbaum M.D. , Ravi Agarwal M.D. , Samuel Melville M.D. , Caroline J. Violette M.D. , Sharon Winer M.D. , Donna Shoupe M.D. , Koji Matsuo M.D., Ph.D. , Richard J. Paulson M.D. , Molly M. Quinn M.D.","doi":"10.1016/j.xfre.2024.03.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To determine the optimal letrozole regimen for ovulation induction (OI) in women with polycystic ovary syndrome (PCOS)</p></div><div><h3>Design</h3><p>Retrospective cohort study.</p></div><div><h3>Setting</h3><p>Single academic fertility clinic from 2015–2022.</p></div><div><h3>Patient(s)</h3><p>A total of 189 OI cycles in 52 patients with PCOS</p></div><div><h3>Intervention(s)</h3><p>Patients were prescribed 1 of 4 letrozole regimens (group 1: 2.5 mg for 5 days, group 2: 2.5 mg for 10 days, group 3: 5 mg for 5 days, and group 4: 5 mg for 10 days).</p></div><div><h3>Main outcome measure(s)</h3><p>The primary outcome was ovulation, and secondary outcomes included multifollicular development, and clinical pregnancy rate, which were analyzed with binary logistic regression. Kaplan-Meier cumulative response curves and a Cox proportional hazard regression model were used for time-dependent analyses.</p></div><div><h3>Results</h3><p>Mean age was 30.9 years (standard deviation [SD], 3.6) and body mass index was 32.1 kg/m<sup>2</sup> (SD, 4.0). Group 2 (odds ratio [OR], 9.12; 95% confidence interval [CI], 1.92–43.25), group 3 (OR, 3.40; 95% CI, 1.57-7.37), and group 4 (OR, 5.94; 95% CI, 2.48–14.23) had improved ovulation rates after the starting regimen as compared with group 1. Cumulative ovulation rates exceeded 84% in all groups, yet those who received 5 mg and/or 10 days achieved ovulation significantly sooner. Multifollicular development was not increased in groups 2–4 as compared with group 1. Groups 2–4 also demonstrated improved time to pregnancy.</p></div><div><h3>Conclusions</h3><p>Ovulation rates are improved when starting with letrozole at 5 mg and/or a 10-day extended course as compared with the frequently-used 2.5 mg for 5 days. This may shorten time to ovulation and pregnancy.</p></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 2","pages":"Pages 170-175"},"PeriodicalIF":0.0000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266633412400045X/pdfft?md5=1e60d051cbd494954a160f964cb35283&pid=1-s2.0-S266633412400045X-main.pdf","citationCount":"0","resultStr":"{\"title\":\"A comparison of letrozole regimens for ovulation induction in women with polycystic ovary syndrome\",\"authors\":\"Rachel S. Mandelbaum M.D. , Ravi Agarwal M.D. , Samuel Melville M.D. , Caroline J. Violette M.D. , Sharon Winer M.D. , Donna Shoupe M.D. , Koji Matsuo M.D., Ph.D. , Richard J. Paulson M.D. , Molly M. Quinn M.D.\",\"doi\":\"10.1016/j.xfre.2024.03.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To determine the optimal letrozole regimen for ovulation induction (OI) in women with polycystic ovary syndrome (PCOS)</p></div><div><h3>Design</h3><p>Retrospective cohort study.</p></div><div><h3>Setting</h3><p>Single academic fertility clinic from 2015–2022.</p></div><div><h3>Patient(s)</h3><p>A total of 189 OI cycles in 52 patients with PCOS</p></div><div><h3>Intervention(s)</h3><p>Patients were prescribed 1 of 4 letrozole regimens (group 1: 2.5 mg for 5 days, group 2: 2.5 mg for 10 days, group 3: 5 mg for 5 days, and group 4: 5 mg for 10 days).</p></div><div><h3>Main outcome measure(s)</h3><p>The primary outcome was ovulation, and secondary outcomes included multifollicular development, and clinical pregnancy rate, which were analyzed with binary logistic regression. Kaplan-Meier cumulative response curves and a Cox proportional hazard regression model were used for time-dependent analyses.</p></div><div><h3>Results</h3><p>Mean age was 30.9 years (standard deviation [SD], 3.6) and body mass index was 32.1 kg/m<sup>2</sup> (SD, 4.0). Group 2 (odds ratio [OR], 9.12; 95% confidence interval [CI], 1.92–43.25), group 3 (OR, 3.40; 95% CI, 1.57-7.37), and group 4 (OR, 5.94; 95% CI, 2.48–14.23) had improved ovulation rates after the starting regimen as compared with group 1. Cumulative ovulation rates exceeded 84% in all groups, yet those who received 5 mg and/or 10 days achieved ovulation significantly sooner. Multifollicular development was not increased in groups 2–4 as compared with group 1. Groups 2–4 also demonstrated improved time to pregnancy.</p></div><div><h3>Conclusions</h3><p>Ovulation rates are improved when starting with letrozole at 5 mg and/or a 10-day extended course as compared with the frequently-used 2.5 mg for 5 days. This may shorten time to ovulation and pregnancy.</p></div>\",\"PeriodicalId\":34409,\"journal\":{\"name\":\"FS Reports\",\"volume\":\"5 2\",\"pages\":\"Pages 170-175\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S266633412400045X/pdfft?md5=1e60d051cbd494954a160f964cb35283&pid=1-s2.0-S266633412400045X-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"FS Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S266633412400045X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"FS Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S266633412400045X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
A comparison of letrozole regimens for ovulation induction in women with polycystic ovary syndrome
Objective
To determine the optimal letrozole regimen for ovulation induction (OI) in women with polycystic ovary syndrome (PCOS)
Design
Retrospective cohort study.
Setting
Single academic fertility clinic from 2015–2022.
Patient(s)
A total of 189 OI cycles in 52 patients with PCOS
Intervention(s)
Patients were prescribed 1 of 4 letrozole regimens (group 1: 2.5 mg for 5 days, group 2: 2.5 mg for 10 days, group 3: 5 mg for 5 days, and group 4: 5 mg for 10 days).
Main outcome measure(s)
The primary outcome was ovulation, and secondary outcomes included multifollicular development, and clinical pregnancy rate, which were analyzed with binary logistic regression. Kaplan-Meier cumulative response curves and a Cox proportional hazard regression model were used for time-dependent analyses.
Results
Mean age was 30.9 years (standard deviation [SD], 3.6) and body mass index was 32.1 kg/m2 (SD, 4.0). Group 2 (odds ratio [OR], 9.12; 95% confidence interval [CI], 1.92–43.25), group 3 (OR, 3.40; 95% CI, 1.57-7.37), and group 4 (OR, 5.94; 95% CI, 2.48–14.23) had improved ovulation rates after the starting regimen as compared with group 1. Cumulative ovulation rates exceeded 84% in all groups, yet those who received 5 mg and/or 10 days achieved ovulation significantly sooner. Multifollicular development was not increased in groups 2–4 as compared with group 1. Groups 2–4 also demonstrated improved time to pregnancy.
Conclusions
Ovulation rates are improved when starting with letrozole at 5 mg and/or a 10-day extended course as compared with the frequently-used 2.5 mg for 5 days. This may shorten time to ovulation and pregnancy.
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