letrozole versus hmg in intrauterine insemination cycles h. jamal; h. serdaroglu; a. baysoy; e....

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Slide 2 Letrozole versus hMG in intrauterine insemination cycles H. Jamal; H. Serdaroglu; A. Baysoy; E. Karatekeli; E. Attar; H. Ozornek Istanbul, Turkey Istanbul, Turkey Slide 3 Aromatase Inhibitors iii-Non-Steroid triazole group: Anastrazole, letrozole i-Steroid group: Exemestane ii-Non-Steroid imidazole group: Fadrozole. Slide 4 letrozole letrozole reversible Slide 5 Enhances ovarian response to gonadotropin stimulation Increases endogenous production of FSH Increasing intraovarian androgen levels Suppressing estrogen Slide 6 Advantages of third-generation aromatase inhibitors Extremely potent inhibition of aromatase Very specific inhibition of aromatase without significant inhibition of other steroidogenesis enzymes Oral administration 100% bioavailability after oral administration Rapid clearance from the body (short half-life, ~ 45 hours) No accumulation of the medications or their metabolites No significant active metabolites Few mild adverse effects with high tolerability when given chronically Few contraindications or drug interactions Relatively inexpensive Slide 7 Indications Ovulation induction Breast cancer Endometrial cancer Endometriosis uterine fibroids a) Unexplained infertility b) PCO c) Poor responders Slide 8 Clinical pregnancy rate Human reproduction Mitwally et al. 2003 0 5 10 15 20 25 Letrozole- FSH CC-FSH FSH-only IUI 19.1% 18.7% 10.5% Slide 9 Clinical pregnancy rate Fertility and Sterility Healey et al. 2003 0 5 10 15 20 25 FSHFSH+Letrozole IUI 20.9% 21.6% Slide 10 A prospective randomized study comparing the results of intrauterine insemination (IUI) in women undergoing ovulation induction with either letrozole or Human Menopausal Gonadotropin (hMG). Objective Slide 11 Letrozole grouphMG group IUI Slide 12 80 couples LETROZOLE GROUP(40 CASES) hMG GROUP(40 CASES) regular menstrual cycles primary infertility female age