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

Yıl 2020, Cilt: 13 Sayı: 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

Öz

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.

Anahtar Kelimeler

etrozol, gonadotropin, endometriozis

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

Öz

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. 

Anahtar Kelimeler

Letrozole, gonadotropin, endometriosis

Kaynakça

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