Endometriozisli hastalarda ovulasyon indüksiyonu ajanı olarak letrozol ve gonedotropinlerin karşılaştırılması: prospektif randomize çalışma

Year 2020, Volume: 13 Issue: 1, 199 - 206, 21.01.2020

Tolga Atakul , S.özlem Altınkaya , Gökalp Öner Mahmut Tuncay Özgün Yılmaz Şahin Ercan Mustafa Aygen

https://doi.org/10.31362/patd.548470

Abstract

Amaç:
Bu çalışmada letrozol ve gonadotropinlerin evre 1-2 endometriozisli infertil
hastalarda ovülasyon indüksiyonu üzerine etkilerinin karşılaştırılması
amaçlanmıştır.

Gereç
ve yöntem: Prospektif randomize olarak dizayn edilen
çalışmaya tanısal laparoskopi yapılan ve histolojik olarak tanı konulan evre
1-2 endometriozisli 20 hasta dahil edildi. Zamanlanmış cinsel ilişki ile devam
etmeyi planlayan hastalar, en az üç en fazla beş ovulasyon indüksiyonu döngüsü
için letrozol (n=10) veya gonadotropinler (n=10) olmak üzere iki tedavi grubuna
ardışık olarak randomize edildi.

Bulgular:
Ovulasyon, letrozol grubunda %82,2 (37/45 siklus) ve gonadotropin grubunda
%86,4 (32/37 siklus) oranlarında gerçekleşti. İki grup arasında ovulasyon
oranları istatistiksel olarak benzerdi (p=0,590). hCG uygulamasının
yapıldığı gün gonadotropin grubunda toplam folikül sayısı anlamlı olarak
yüksekti (2,33±0,71 ve 3,05±0,91, p<0,001). Klinik gebelik oranları hem
tamamlanmış siklus başına hem de hasta başına iki grup arasında benzerdi
(sırasıyla siklus başına %8,1 ve %9,4  p=0,850 ve hasta başına %30
ve%30, p=1,000).

Sonuç:
Letrozol iyi tolere edilebilen bir ovulasyon indüksiyonu ajanıdır.  Evre
1-2 Endometriozisli hastalarda letrozolün ovülasyon indüksiyonu üzerindeki
etkileri gonadotropinlerle karşılaştırılabilir bulunmuştur.

Keywords

etrozol, gonadotropin, endometriozis

Letrozole versus gonadotropins for ovulation induction in patients with endometriosis: a prospective randomized trial

Abstract

Purpose: This study aimed to compare the
effects of letrozole and gonadotropins for ovulation induction in infertile
patients with stage 1-2 endometriosis.

Materials and methods: Twenty patients who underwent
diagnostic laparoscopy and histologically diagnosed stage 1-2 endometriosis
were included in this prospective randomized study.   Patients who
planned to continue with timed sexual intercourse were randomized into two
treatment groups including letrozole (n=10) or gonadotropins (n=10) for minimum
three and maximum five treatment cycles.

Results: Ovulation occurred in 37/45
cycles (82.2%) in the letrozole group and 32/37 cycles (86.4%) in the
gonadotropin group, without statistically significant difference (p=0.590).
Total number of follicles was significantly higher in gonadotropin group on the
day of hCG administration (2.33±0.71 vs. 3.05±0.91, p<0.001).
Clinical pregnancy rates both per completed cycles and per patients were
similar between two groups (8.1% vs. 9.4%, p=0.850 and 30% vs. 30%, p=1.000;
respectively).

Conclusions: Letrozole is well tolerated and
cost effective ovulation induction agent in patients with endometriosis and
effects of letrozole for ovulation induction were comparable to
gonadotropins. 

Keywords

Letrozole, gonadotropin, endometriosis

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