scholarly journals The Use of High Dose Letrozole in Ovulation Induction and Controlled Ovarian Hyperstimulation

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Elizabeth A. Pritts ◽  
Alexander K. Yuen ◽  
Shefaali Sharma ◽  
Robert Genisot ◽  
David L. Olive
Keyword(s):  
Ovulation Induction ◽  
Detrimental Effect ◽  
Endometrial Thickness ◽  
Controlled Ovarian Hyperstimulation ◽  
High Dose ◽  
Ovarian Hyperstimulation ◽  
Dose Administration ◽  
Treatment Groups ◽  
Starting Dose ◽  
Higher Doses

Letrozole, an aromatase inhibitor, has been demonstrated to be effective as an ovulation induction and controlled ovarian hyperstimulation agent. However, dose administration has generally been limited to 5 days at 2.5 to 7.5 mg daily. We undertook a retrospective review of over 900 treatment cycles using letrozole in doses as high as 12.5 mg per day. Results indicate that such doses do indeed offer benefit to patients; in that there is increased follicular growth and a higher number of predicted ovulations with higher doses of the drug. However, increasing doses does not produce a detrimental effect upon endometrial thickness. High-dose letrozole may be of value in women who fail to respond adequately to lower doses. Furthermore, randomized trials are needed to determine whether high-dose letrozole might actually be optimal as a starting dose for certain treatment groups.

scholarly journals A study on outcome of controlled ovarian hyperstimulation and intrauterine insemination (husband) in a medical college in Kolkata

2022 ◽  
Vol 13 (1) ◽  
pp. 136-141
Author(s):  
Rajib Roy ◽  
Agniv Sarkar ◽  
Bibhas Saha Dalal
Keyword(s):  
Success Rate ◽  
Ovulation Induction ◽  
Positive Impact ◽  
Endometrial Thickness ◽  
Intrauterine Insemination ◽  
Controlled Ovarian Hyperstimulation ◽  
Infertile Couple ◽  
P Value ◽  
Ovarian Hyperstimulation ◽  
Resource Setting

Background: A combination of controlled ovarian hyperstimulation and intrauterine insemination (IUI) remains an important treatment option for couple having infertility. Success rate of IUI with ovulation induction ranges from 8-20% depending on many factors. Aims and Objectives: To assess the factors affecting the success rate of IUI and to evaluate the success of ovulation Induction by different methods of controlled stimulation protocol. Materials and Methods: It is a duration-based prospective cross-sectional study where total of 67 couples were included by inclusion and exclusion criteria. They underwent 90 cycles of IUI with each couple having a maximum of three cycles. Ovulation induction was done by clomiphene citrate or letrozole or gonadotrophins. Semen preparation was done by density gradient method. The outcomewas measured by positive urine pregnancy test. Range, percentage, confidence interval, mean with standard deviation, median, range, and P-value were calculated. P<0.05 was taken as statistically significant. Results: Out of 90 IUI cycles 8 were successful resulting in a success rate of 8.8% per cycle and 11.9% per couple. Factors that had a positive impact were follicle size >21 sqmm, endometrial thickness >9 mm, post wash count >15 million/ml, >2 cycles of IUI and on the number of follicles 2 or more on the day of trigger. Conclusion: The study concluded that IUI after ovulation induction can be a simple and safe cost-effective procedure in selected group of infertile couple. Clinical significance IUI following ovulation induction can be a successful approach for specific indications in a low-resource setting where options for other ART interventions are absent or limited.

scholarly journals Adjuvant Growth Hormone for Ovulation Induction with Gonadotropins in the Treatment of a Woman with Hypopituitarism

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Ariadne Daniel ◽  
Shereen Ezzat ◽  
Ellen Greenblatt
Keyword(s):  
Growth Hormone ◽  
Ovulation Induction ◽  
Gh Deficiency ◽  
Pregnancy Rates ◽  
Small Subset ◽  
High Dose ◽  
Human Menopausal Gonadotropin ◽  
Deficient Patient ◽  
Igf I ◽  
Higher Doses

Objective. To report the prestimulation use of adjuvant GH for gonadotropin ovulation induction in a woman with hypopituitarism and GH deficiency who previously failed to respond.Design, Patients, and Measurements. A 31-year-old nulliparous woman presented with hypopituitarism and GH deficiency after failing ovulation induction with high dose gonadotropins. A trial of GH was undertaken for 5 months prior to ovulation induction resulting in normalization of IGF-I levels.Results. Women with hypopituitarism are known to have lower pregnancy rates after ovulation induction with need for higher doses of gonadotropins. A small subset of these patients do not ovulate. This patient had successful ovulation induction and pregnancy with prestimulation GH.Conclusions. This case suggests that the use of adjuvant GH in a GH-deficient patient several months before the use of human menopausal gonadotropin results in ovulation and pregnancy.

scholarly journals Controlled Ovarian Hyperstimulation Protocol in Infertile Patients During the COVID-19 Pandemic

2021 ◽  
Vol 12 ◽  
Author(s):  
Fei Li ◽  
HuiXia Zhang ◽  
WeiYi Shi ◽  
YiFang Wu ◽  
Ye Tian ◽  
...  
Keyword(s):  
Endometrial Thickness ◽  
Management Strategies ◽  
Implantation Rate ◽  
Controlled Ovarian Hyperstimulation ◽  
Ovarian Hyperstimulation ◽  
Down Regulation ◽  
Cycle Number ◽  
Full Dose ◽  
Infertility Patients

Objectives: To explore the appropriate controlled ovarian hyperstimulation (COH) protocols in infertility patients who received the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatments during the COVID-19 pandemic.Materials and Methods: This retrospective cohort study evaluated the efficiency of the early follicular-phase long-acting GnRH-agonist long (EFLL) protocol (a new protocol developed by Chinese clinicians), prolonged pituitary down-regulation of EFLL protocol (Pro-EFLL), and the GnRH-ant protocol for couples meeting the study criteria between February 2020 and June 2020 who were treated by the First Affiliated Hospital of Zhengzhou University during the COVID-19 pandemic, and compared the pregnancy rates and miscarriage rates per fresh transfer cycle, number of retrieved oocytes, endometrial thickness on the day of hCG injection and the number of fertilized oocytes, mature oocytes, fertilized oocytes, and transferable embryos among the three protocols.Results: We found that the prolonged pituitary down-regulation during the COVID-19 pandemic by utilizing a full-dose of GnRH-a administrated in infertility patients were no differences in clinical outcomes than other protocols, The prolonged pituitary down-regulation protocol and EFLL protocol were associated with a higher Endometrial thickness on the day of hCG injection (12.67 ± 2.21 vs. 12.09 ± 2.35 vs. 10.79 ± 2.38, P &lt; 0.001), retrieved oocytes (14.49 ± 6.30 vs. 15.02 ± 7.93 vs. 10.06 ± 7.63, P &lt; 0.001), mature oocytes (11.60 ± 5.71 vs. 11.96 ± 6.00 vs. 7.63 ± 6.50, P &lt; 0.001), fertilized oocytes (9.14 ± 5.43 vs. 8.44 ± 5.34 vs. 5.42 ± 5.20, P &lt; 0.001), and transferable embryos (4.87 ± 2.96 vs. 6.47 ± 5.12 vs. 3.00 ± 3.28 vs. P &lt; 0.001) in the GnRH-antagonist protocol.Conclusion: We recommend that patients start Gn injections 33–42 days after a pituitary downregulated full dose (3.75 mg) of gonadotropin-releasing hormone agonist during the COVID-19 pandemic, even a delay of 2–4 weeks does not affect the implantation rate. The study can provide a more detailed estimate and clinical management strategies for infertile couples during the COVID-19 pandemic.

scholarly journals Quercetin Mitigates Oxidative Stress, Developmental Toxicity and Teratogenic Effects Induced by High-dose Vitamin D2 in Zebrafish Embryos

2021 ◽  
Vol 22 (3) ◽  
Author(s):  
Sukkum Ngullie Chang ◽  
Hyun Jin Kim ◽  
Sun Chul Kang
Keyword(s):  
Developmental Toxicity ◽  
Morphological Characteristics ◽  
Visual Assessment ◽  
High Dose ◽  
Zebrafish Embryos ◽  
Vitamin D2 ◽  
Teratogenic Effects ◽  
Dose Administration ◽  
Treatment Groups ◽  
Intracellular Ros

The aim of the study was to determine the developmental toxicity of high-dose administration of vitamin D2 (vit. D2) and the synergistic effect of vit. D2 inco-treatment with quercetin. Zebrafish embryos at 6 hpf were treated with either vit. D2 (1, 5, 10 μg/mL) or quercetin (5, 10 μg/mL) alone. The results from visual assessment and morphological feature scoring revealed, the occurrence of different morphological abnormalities spiked and aggravated with an increase in vit. D2 dose. The percentage of hatching, heartbeats/minute, velocity, body length, and survivability rate was downregulated in high dose vit. D2 groups. Subsequently, the production of proinflammatory cytokines and intracellular ROS was upregulated in high-dose vit. D2 groups. Contrastingly, in the co-treatment of vit. D2 (5 μg/mL) and quercetin (1, 5, 10 μg/mL), the occurrence of abnormal morphological characteristics was downregulated and the percentage of survivability rate was significantly increased. The production of inflammatory cytokines, intracellular ROS, and MDA was also observed to be inhibited in co-treatment groups. The important antioxidants such as glutathione and catalase were increased in co-treatment groups. The activity of S-A-β gal and apoptosis was downregulated in co-treatment groups. Collectively, quercetin ameliorated the developmental toxicity and teratogenic effects induced by high-dose vit. D2.

scholarly journals Clomiphene citrate plus N-acetyl cysteine versus letrozole for induction of ovulation in infertile patients with polycystic ovarian disease: a randomized clinical trial

2019 ◽  
Vol 8 (10) ◽  
pp. 3959
Author(s):  
Momen A. Kamel ◽  
Ahmed F. Amin ◽  
Tarek A. Farghaly ◽  
Nawal A. Farrag
Keyword(s):  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Clinical Pregnancy ◽  
Ovulation Rate ◽  
Ovarian Hyperstimulation ◽  
Polycystic Ovarian Disease ◽  
Ovarian Disease ◽  
Infertile Patients

Background: Polycystic ovarian disease (PCOD), a common endocrine disorder with multisystem affection, is the most common cause of anovulatory infertility. Our objective is to evaluate the effect of using clomiphene citrate (CC) plus N-acetyl cysteine (NAC) versus letrozole in ovulation induction in infertile patients with PCOD.Methods: Reproductive-aged infertile women either primary or secondary diagnosed as PCOD according to Rotterdam criteria, 2003 were considered for enrollment. Eligible women for were recruited and randomized (1:1) to receive either CC 100 mg plus NAC 600 mg (CC+NAC arm) or letrozole 5 mg (NCT03241472, clinicaltrials.gov). All medications were started from day 3 of the menstrual cycle for 5 days. The primary outcome was the ovulation rate in both groups. Secondary outcomes included the mid-cyclic endometrial thickness, ovarian hyperstimulation, and clinical pregnancy and miscarriage rates.Results: One hundred ten patients were enrolled and randomized to CC+NAC arm (n=55) or letrozole (n=55). The ovulation rate in patients in letrozole arm was significantly higher than CC+NAC arm (71.8% versus 53.2%, p=0.01). Additionally, endometrial thickness was higher in letrozole arm (mean±SD: 11.46±1.61 versus 9.0±1.13, p=0.031). However, no statistical significant difference with regarding the ovarian hyperstimulation rate (1.8% versus 3.6%, p=0.157), clinical pregnancy rate [3/19 patients (27.3%) versus 19/55 (34.5%), p=0.409] and miscarriage rate [4/15 patients (26.7%) versus 19/55 (15.8%), p=0.317] in CC+NAC versus letrozole groups respectively.Conclusions: Addition of NAC to CC in ovulation induction leads to comparable pregnancy rate as letrozole. However, letrozole produces high ovulation rate and the better mid-cyclic endometrial thickness.

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