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Korean Journal of Reproductive Medicine 2008;35(2):143-153.
Published online June 1, 2008.
Effects of Aromatase Inhibitor on Reproductive Hormone Profiles and Ovulation Induction.
Sook Hyun Kim, Jeong Ah Kim, Joon Cheol Park, Jin Gon Bae, So Jin Shin, Sang Hoon Kwon, Chi Heum Cho, Sung Do Yoon, Soon Do Cha, Jong In Kim, Jeong Ho Rhee
Department of Obstetrics and Gynecology, School of Medicine, Keimyung University, Daegu, Korea.
Abstract
OBJECTIVE
To investigate the effects of aromatase inhibitor on reproductive hormone profiles and evaluate it's ovulation inducing capability in anovulatory infertile women. METHODS: We quantified the blood levels of reproductive hormones from 30 healthy normal cycling women in natural cycle (control) and letrozole medicated cycle (study). LH, FSH, estradiol, testosterone, DHEA-S were quantified on third, 11th, 21th day in both cycles, and on 21th day, progesterone was added. Sixth anovulatory infertile women received either letrozole or clomiphene citrate for ovulation induction (n=30 in each groups). We compared the clinical parameters such as ovulation rate, pregnancy rate, the day of LH surge, number of follicles and endometrial thickness, cervical mucus amount, spinnbarkeit, mean diameter of follicles on the day of LH surge. RESULTS: Letrozole had no effect on the LH, FSH, estradiol, DHEA-S secretion but there were significant increase in testosterone level on day 11 and progesterone level on day 21 in letrozole medicated cycle compared than control cycle (0.40+/-0.16 vs 0.28+/-0.11 ng/ml, p=0.002, 18.18+/-13.07 vs 8.38+/-7.64 ng/ml, p=0.001, respectively). In comparison between letrozole and clomiphene groups, there were no significant difference in ovulation rate, pregnancy rate, number of mature follicle, mean diameter of follicles, but showed earlier LH surge, thicker endometrium, more cervical mucus, and higher spinnbarkeit in letrozole group (12.12+/-2.46 vs 14.52+/-3.18 days, p=0.006, 10.48+/-1.23 vs 8.52+/-0.93 mm, p=0.000, 2.04+/-0.61 vs 1.57+/-0.59, p=0.012, 6.00+/-1.12 vs 4.95+/-1.61 cm, p=0.003, respectively). CONCLUSION: Letrozole may augment folliculogenesis and improve the endometrial condition for implantation in normal cycling women. Ovulation efficacy of letrozole in anovulatory women was comparable to clomiphene citrate and letrozole may be more physiological in ovulation induction.
Key Words: Aromatase inhibitor; Letrozole; Clomiphene citrate; Ovulation


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