dc.contributor.author |
Palihawadana, T.S. |
|
dc.contributor.author |
Wijesinghe, P.S. |
|
dc.contributor.author |
Seneviratne, H.R. |
|
dc.date.accessioned |
2015-08-25T05:15:24Z |
|
dc.date.available |
2015-08-25T05:15:24Z |
|
dc.date.issued |
2015 |
|
dc.identifier.citation |
Journal of Human Reproductive Sciences.2015;8(2):75-9 |
en_US |
dc.identifier.issn |
0974-1208 (Print) |
|
dc.identifier.issn |
1998-4766 (Electronic) |
|
dc.identifier.uri |
http://repository.kln.ac.lk/handle/123456789/9284 |
|
dc.description |
Indexed in Scopus; In PUBMED; Not Indexed in MEDLINE |
en_US |
dc.description.abstract |
CONTEXT: Letrozole, a third generation aromatase inhibitor is gaining importance in ovulation induction. Some prefer to use it as a second line agent in women who fail to respond to clomifene citrate. However, our knowledge about the predictors of response to letrozole is limited. AIMS: The study was aimed at identifying the factors associated with letrozole resistance among women with World Health Organization (WHO) group II anovulation. SUBJECTS AND METHODS: Study was conducted at the infertility clinic at a tertiary care hospital in Sri Lanka. A case–control study design was used and included 50 subjects with WHO group II anovulation (25 clomifene responsive and 25 clomifene resistant). After a treatment cycle of letrozole, the factors were compared between the subjects who responded and those who failed to respond to treatment. RESULTS: Ovulation was achieved in 76% (n = 19) of subjects who had responded to clomifene previously and in 24% (n = 6) with clomifene resistance. The factors associated with letrozole resistance included the presence of hirsutism (odds ratio [OR]: 3.89; 95% confidence interval [CI]: 1.2–12.3) and clomifene resistance (OR: 10.03; 95% CI: 2.81–35.7). The early follicular phase mean (standard deviation) luteinizing hormone level was significantly higher among the nonresponders (9.75 [4.78] – 7.28 [2.3]; P = 0.02). Nonresponders showed significantly lower levels of oestradiol on the 5th and 9th days (28.50 [3.39] pg/mL vs. 7.49 [3.62] pg/mL; P = 0.0007 and 142.04 [76.22] pg/mL vs. 28.10 [12.8] pg/mL; P = 0.0001) of the menstrual cycle, respectively. CONCLUSIONS: The features associated with resistance to Letrozole at a dose of 2.5 mg show some overlap with those associated with clomifene resistance. However, some features do not show similar association. The effectiveness of letrozole at a dose of 2.5 mg in induction of ovulation among women with clomifene resistance is low and it does not seem to be a suitable treatment at a dose of 2.5 mg for this indication. |
en_US |
dc.language.iso |
en_US |
en_US |
dc.publisher |
Medknow Publications |
en_US |
dc.subject |
Ovulation induction |
en_US |
dc.title |
Factors associated with nonresponse to ovulation induction using letrozole among women with World Health Organization group II anovulation |
en_US |
dc.type |
Article |
en_US |