%0 Journal Article
%T A comparison of letrozole regimens for ovulation induction in women with polycystic ovary syndrome.
%A Mandelbaum RS
%A Agarwal R
%A Melville S
%A Violette CJ
%A Winer S
%A Shoupe D
%A Matsuo K
%A Paulson RJ
%A Quinn MM
%J F S Rep
%V 5
%N 2
%D 2024 Jun
%M 38983726
暂无%R 10.1016/j.xfre.2024.03.004
%X <B>UNASSIGNED: </B>To determine the optimal letrozole regimen for ovulation induction (OI) in women with polycystic ovary syndrome (PCOS).<BR><B>UNASSIGNED: </B>Retrospective cohort study.<BR><B>UNASSIGNED: </B>Single academic fertility clinic from 2015-2022.<BR><B>UNASSIGNED: </B>A total of 189 OI cycles in 52 patients with PCOS.<BR><B>UNASSIGNED: </B>Patients were prescribed 1 of 4 letrozole regimens (group 1: 2.5 mg for 5 days, group 2: 2.5 mg for 10 days, group 3: 5 mg for 5 days, and group 4: 5 mg for 10 days).<BR><B>UNASSIGNED: </B>The primary outcome was ovulation, and secondary outcomes included multifollicular development, and clinical pregnancy rate, which were analyzed with binary logistic regression. Kaplan-Meier cumulative response curves and a Cox proportional hazard regression model were used for time-dependent analyses.<BR><B>UNASSIGNED: </B>Mean age was 30.9 years (standard deviation [SD], 3.6) and body mass index was 32.1 kg/m2 (SD, 4.0). Group 2 (odds ratio [OR], 9.12; 95% confidence interval [CI], 1.92-43.25), group 3 (OR, 3.40; 95% CI, 1.57-7.37), and group 4 (OR, 5.94; 95% CI, 2.48-14.23) had improved ovulation rates after the starting regimen as compared with group 1. Cumulative ovulation rates exceeded 84% in all groups, yet those who received 5 mg and/or 10 days achieved ovulation significantly sooner. Multifollicular development was not increased in groups 2-4 as compared with group 1. Groups 2-4 also demonstrated improved time to pregnancy.<BR><B>UNASSIGNED: </B>Ovulation rates are improved when starting with letrozole at 5 mg and/or a 10-day extended course as compared with the frequently-used 2.5 mg for 5 days. This may shorten time to ovulation and pregnancy.