Letrozole versus clomiphene citrate for unexplained infertility: A systematic review and meta-analysis

Journal of Obstetrics and Gynaecology Research

Volumn 40, Issue 5, 2014, Pages 1205-1216

  Liu, Aihai ^a   Zheng, Chao ^a   Lang, Junzhe ^b   Chen, Wenbing ^a  

^a THE SECOND AFFILIATED HOSPITAL AND YUYING CHILDREN S HOSPITAL OF WENZHOU MEDICAL UNIVERSITY   (China)

^b THE FIRST AFFILIATED HOSPITAL OF WENZHOU MEDICAL UNIVERSITY   (China)

Author keywords

Clomiphene citrate; Letrozole; Unexplained infertility

Indexed keywords

CHORIONIC GONADOTROPIN; CLOMIFENE CITRATE; ESTRADIOL; LETROZOLE; CLOMIFENE; FOLLITROPIN; NITRILE; TRIAZOLE DERIVATIVE;

ADVERSE OUTCOME; CONFIDENCE INTERVAL; CONGENITAL MALFORMATION; ECTOPIC PREGNANCY; ENDOMETRIAL THICKNESS; ESTRADIOL BLOOD LEVEL; FEMALE; FEMALE INFERTILITY; HUMAN; HYDATIDIFORM MOLE; INFERTILITY THERAPY; META ANALYSIS; MULTIPLE PREGNANCY; OUTCOMES RESEARCH; OVARY FOLLICLE; PREGNANCY RATE; RANDOMIZED CONTROLLED TRIAL (TOPIC); RECOMMENDED DRUG DOSE; REVIEW; RISK ASSESSMENT; SPONTANEOUS ABORTION; SYSTEMATIC REVIEW; TREATMENT OUTCOME; UNEXPLAINED INFERTILITY; ABORTION, SPONTANEOUS; ANATOMY AND HISTOLOGY; BLOOD; COMPARATIVE STUDY; ENDOMETRIUM; INFERTILITY, FEMALE; PREGNANCY; STATISTICAL BIAS; STATISTICS AND NUMERICAL DATA; DRUG EFFICACY; DRUG SAFETY; INCIDENCE; INFERTILITY; RISK FACTOR;

ABORTION, SPONTANEOUS; BIAS (EPIDEMIOLOGY); CLOMIPHENE; ENDOMETRIUM; ESTRADIOL; FEMALE; FOLLICLE STIMULATING HORMONE; HUMANS; INFERTILITY, FEMALE; NITRILES; PREGNANCY; PREGNANCY RATE; PREGNANCY, MULTIPLE; TRIAZOLES;

EID: 84903635057     PISSN: 13418076     EISSN: 14470756     Source Type: Journal    
DOI: 10.1111/jog.12393     Document Type: Review

References (41)

1. Hatasaka H. New perspectives for unexplained infertility. Clin Obstet Gynecol 2011; 54: 727-733.
2. Evers JL. Female subfertility. Lancet 2002; 360: 151-159. (Pubitemid 34786208)
3. Collins J. Stimulated intra-uterine insemination is not a natural choice for the treatment of unexplained subfertility. Current best evidence for the advanced treatment of unexplained subfertility. Hum Reprod 2003; 18: 907-912.
4. Dankert T, Kremer JA, Cohlen BJ et al. A randomized clinical trial of clomiphene citrate versus low dose recombinant FSH for ovarian hyperstimulation in intrauterine insemination cycles for unexplained and male subfertility. Hum Reprod 2007; 22: 792-797.
5. Kettel LM, Roseff SJ, Berga SL, Mortola JF, Yen SS. Hypothalamic- pituitary-ovarian response to clomiphene citrate in women with polycystic ovary syndrome. Fertil Steril 1993; 59: 532-538. (Pubitemid 23086308)
6. Athaullah N, Proctor M, Johnson NP. Oral versus injectable ovulation induction agents for unexplained subfertility. Cochrane Database Syst Rev 2002; (3): CD003052.
7. Pfister CU, Martoni A, Zamagni C et al. Effect of age and single versus multiple dose pharmacokinetics of letrozole (Femara) in breast cancer patients. Biopharm Drug Dispos 2001; 22: 191-197. (Pubitemid 33133815)
8. Fouda UM, Sayed AM. Extended letrozole regimen versus clomiphene citrate for superovulation in patients with unexplained infertility undergoing intrauterine insemination: A randomized controlled trial. Reprod Biol Endocrinol 2011; 9: 84.
9. Requena A, Herrero J, Landeras J et al. Use of letrozole in assisted reproduction: A systematic review and metaanalysis. Hum Reprod Update 2008; 14: 571-582.
10. Mitwally MF, Biljan MM, Casper RF. Pregnancy outcome after the use of an aromatase inhibitor for ovarian stimulation. Am J Obstet Gynecol 2005; 192: 381-386. (Pubitemid 40214968)
11. Thessaloniki EA-SPCWG. Consensus on infertility treatment related to polycystic ovary syndrome. Hum Reprod 2008; 23: 462-477.
12. Homburg R. Oral agents for ovulation induction-clomiphene citrate versus aromatase inhibitors. Hum Fertil 2008; 11: 17-22.
13. Eden JA, Place J, Carter GD, Jones J, Alaghband-Zadeh J, Pawson ME. The effect of clomiphene citrate on follicular phase increase in endometrial thickness and uterine volume. Obstet Gynecol 1989; 73: 187-190. (Pubitemid 19046529)
14. Palomba S, Russo T, Orio F, Jr et al. Uterine effects of clomiphene citrate in women with polycystic ovary syndrome: A prospective controlled study. Hum Reprod 2006; 21: 2823-2829. (Pubitemid 44566993)
15. Badawy A, Elnashar A, Totongy M. Clomiphene citrate or aromatase inhibitors for superovulation in women with unexplained infertility undergoing intrauterine insemination: A prospective randomized trial. Fertil Steril 2009; 92: 1355-1359.
16. Badawy A, Shokeir T, Allam AF, Abdelhady H. Pregnancy outcome after ovulation induction with aromatase inhibitors or clomiphene citrate in unexplained infertility. Acta Obstet Gynecol Scand 2009; 88: 187-191.
17. Al-Fozan H, Al-Khadouri M, Tan SL, Tulandi T. A randomized trial of letrozole versus clomiphene citrate in women undergoing superovulation. Fertil Steril 2004; 82: 1561-1563. (Pubitemid 39611383)
18. Ibrahim MI, Moustafa RA, Abdel-Azeem AA. Letrozole versus clomiphene citrate for superovulation in Egyptian women with unexplained infertility: A randomized controlled trial. Arch Gynecol Obstet 2012; 286: 1581-1587.
19. ElKattan EA. Ultrasonographic markers of endometrial receptivity of letrozole and clomiphene citrate in unexplained infertile women. Middle East Fertil Soc J 2013; 18: 84-88.
20. Polyzos NP, Tzioras S, Mauri D et al. Treatment of unexplained infertility with aromatase inhibitors or clomiphene citrate:A systematic review and meta-analysis. Obstet Gynecol Surv 2008; 63: 472-479.
21. World Health O. [Laboratory manual of the WHO for the examination of human semen and sperm-cervical mucus interaction]. Ann Ist Super Sanita 2001; 37 (I-XII): 1-123.
22. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. Available from URL: http://www.cochrane-handbook.org The Cochrane Collaboration 2011.
23. Sammour A, Biljan MM, Tan SL, da Fonseca LM. Prospective randomized trial comparing the effects of letrazole (LE) and clomiphene citrate (CC) on follicular development, endometrial thickness and pregnancy rate in patients undergoing super-ovulation prior to intrauterine insemination (IUI). Fertil Steril 2001; 76: 110.
24. Schulz KF, Chalmers I, Hayes RJ, Altman DG. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 1995; 273: 408-412.
25. Moher D, Pham B, Jones A et al. Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses? Lancet 1998; 352: 609-613. (Pubitemid 28380142)
26. Kjaergard LL, Villumsen J, Gluud C. Reported methodologic quality and discrepancies between large and small randomized trials in meta-analyses. Ann Intern Med 2001; 135: 982-989. (Pubitemid 33131619)
27. Egger M, Jüni P, Bartlett C, Holenstein F, Sterne J. How important are comprehensive literature searches and the assessmentof trialquality in systematic reviews? Empirical study. Health Technol Assess 2003; 7: 1-76.
28. Wood L, Egger M, Gluud LL et al. Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: Meta-epidemiological study. BMJ 2008; 336: 601-605. (Pubitemid 351439518)
29. Al-Fadhli R, Sylvestre C, Buckett W, Tan SL, Tulandi T. A randomized trial of superovulation with two different doses of letrozole. Fertil Steril 2006; 85: 161-164. (Pubitemid 43063440)
30. Badawy A, Metwally M, Fawzy M. Randomized controlled trial of three doses of letrozole for ovulation induction in patients with unexplained infertility. Reprod Biomed Online 2007; 14: 559-562.
31. Veltman-Verhulst SM, Cohlen BJ, Hughes E, Heineman MJ. Intra-uterine insemination for unexplained subfertility. Cochrane Database Syst Rev 2012; (9): CD001838.
32. Ramezanzadeh F, Nasiri R, Sarafraz Yazdi M, Baghrei M. A randomized trial of ovulation induction with two different doses of Letrozole in women with PCOS. Arch Gynecol Obstet 2011; 284: 1029-1034.
33. Mitwally MF, Casper RF. Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate. Fertil Steril 2001; 75: 305-309. (Pubitemid 32112106)
34. Weil S, Vendola K, Zhou J, Bondy CA. Androgen and folliclestimulating hormone interactions in primate ovarian follicle development. J Clin Endocrinol Metab 1999; 84: 2951-2956. (Pubitemid 30642034)
35. Mitwally MF, Casper RF. Aromatase inhibition reduces gonadotrophin dose required for controlled ovarian stimulation in women with unexplained infertility. Hum Reprod 2003; 18: 1588-1597. (Pubitemid 36958035)
36. Abdellah MS. Reproductive outcome after letrozole versus laparoscopic ovarian drilling for clomiphene-resistant polycystic ovary syndrome. Int J Gynaecol Obstet 2011; 113: 218-221.
37. Sioufi A, Sandrenan N, Godbillon J et al. Comparative bioavailability of letrozole under fed and fasting conditions in 12 healthy subjects after a 2.5 mg single oral administration. Biopharm Drug Dispos 1997; 18: 489-497. (Pubitemid 27338980)
38. Casper RF, Mitwally MF. Review: Aromatase inhibitors for ovulation induction. J Clin Endocrinol Metab 2006; 91: 760-771. (Pubitemid 43361917)
39. Biljan MM, Hemmings R, Brassard N. The outcome of 150 babies following the treatment with letrozole or letrozole and gonadotropins. Fertil Steril 2005; 84: S95.
40. Tulandi T, Martin J, Al-Fadhli R et al. Congenital malformations among 911 newborns conceived after infertility treatment with letrozole or clomiphene citrate. Fertil Steril 2006; 85: 1761-1765. (Pubitemid 43816444)
41. Finnell RH. Teratology: General considerations and principles. J Allergy Clin Immunol 1999; 103: S337-S342. (Pubitemid 29095810)