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Oct 2018, Vol 6, Issue 4
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Original Article
Letrozole Plus two Different Gonadotropins Regimens For Intrauterine Insemination In Polycystic Ovary Patients: RCT
Mina Naghi Jafarabadi1, Seyedeh Houra MosaviVahed2, Malihe Afiat2, Zahra Ebrahimi3, Zahra Sadat Shiva4, Fedyeh Haghollahi1
1Vali - Asr Reproductive Health Research Center, Tehran University Of Medical Sciences,Tehran, Iran
2Department of Obstetrics and Gynecology,Women's Health Research Center,  Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
3Imam Hospital, Tehran University Of Medical Sciences, Tehran-Iran.
4Department of Obstetrics and Gynecology; Faculty of Medicine, Mashhad University of Medical Sciences. Mashhad, Ira


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Keywords : HMG, Letrozole, Ovulation induction, Recombinant FSH, Polycystic ovary syndrome
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Abstract

Objectives: The purpose of this study was to compare the effects of letrozole plus recombinant follicle stimulating hormone (R-FSH) and human menopausal gonadotropin (HMG) on ovarian stimulation in intrauterine insemination (IUI) cycle.

Materials and Methods: This randomized clinical trial was conducted on 130 women with polycystic ovary syndrome (PCOS) resistant to clomiphene and letrozole who were divided into A and B groups. Both groups received 5 mg of letrozole daily from the third to seventh day of the cycle and then the group A (n=59) received 75 units of HMG intramuscularly per day and the group B received 75 units of R-FSH subcutaneously per day. Follicular maturation was triggered by with 250 μg of recombinant human chorionic gonadotrophin (R-HCG) and IUI was performed 36 hours later. Main results under study were the number of matured follicles, endometrial thickness on the day of HCG injection, and the rate of chemical and clinical pregnancy.

Results:  The two groups were not significantly different in demographic information. The rate of pregnancy in the letrozole+R-FSH group was significantly higher than in the letrozole+HMG group (20% and 5.8% respectively, p=0.04). There was no significant difference between the two groups in the number of mature follicles (18 mm ≤) and endometrial thickness at the time of HCG injection (p>0.05).

Conclusion: Letrozole plus R-FSH is a recommended regimen for ovarian stimulation in PCOS patients.

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