المؤلفون: Ma, Hanghao, Chen, Yan

المصدر: PLoS ONE; 6/7/2024, Vol. 19 Issue 6, p1-14, 14p

مصطلحات موضوعية: MALE infertility, GLOBULINS, SINGLE nucleotide polymorphisms, REGRESSION analysis, ANOVULATION, FEMALE infertility

مصطلحات جغرافية: UNITED Kingdom

مستخلص: Background: The causal relationship between sex hormone-binding globulin (SHBG) and infertility has remained unclear. Thus, we used Mendelian randomization (MR) to investigate this relationship. Methods: Risk factors for SHBG were extracted from European individuals within the UK Biobank using single-nucleotide polymorphism (SNP) data. Summary-level data for infertility outcomes were obtained from the FinnGen dataset. The causal relationship between SHBG and infertility was examined using inverse variance weighted, weighted model, weighted median, and MR-Egger regression analyses. Additionally, Cochran's Q test and Egger intercept tests were used to confirm the heterogeneity and pleiotropy of identified instrumental variables (IVs). Results: Our findings revealed a significant negative association between sex hormone-binding globulin (SHBG) levels and infertility, particularly with anovulation, a specific form of female infertility. However, SHBG did not exert a causal impact on male infertility or on female infertility of tubal origin. Conclusions: SHBG expression offers protection against the development of certain types of female infertility, suggesting it is a potential therapeutic target for infertility. [ABSTRACT FROM AUTHOR]

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المؤلفون: Salamunes, Ana Carla C., Williams, Nancy I., De Souza, Mary Jane

المصدر: Applied Physiology, Nutrition & Metabolism; 2024, Vol. 49 Issue 5, p584-598, 15p

مصطلحات موضوعية: EXERCISE, FOOD consumption, LUTEAL phase, ENERGY metabolism, TRIIODOTHYRONINE, LUTEINIZING hormone, LEAN body mass, MENSTRUAL cycle, MENSTRUATION disorders, ANOVULATION

مستخلص: Exercising women have a high prevalence of menstrual disturbances. In 2003, it was suggested that disruption in luteinizing hormone (LH) pulsatility occurs below a threshold of energy availability (EA) of 30 kcal/kg lean body mass (LBM)/day. This paper is a critical review of the evidence regarding the theory that disruptions to the reproductive axis and menstrual disturbances occur below the proposed threshold. Short-term laboratory studies demonstrated that 4–5 days of an EA below 30 kcal/kg LBM/day, induced with or without exercise, decreased serum triiodothyronine and LH pulse frequency, and increased LH pulse amplitude in sedentary, regularly menstruating women. Fewer studies have investigated downstream ovarian effects after long-term exposure to low EA. The Sargent Camp Study was the first randomized trial that induced luteal phase defects, delayed menses, and anovulation by causing weight loss (−4 ± 0.3 kg) with an abrupt increase in exercise volume for two menstrual cycles. The BioEnergetics Study was a randomized controlled trial that induced varying levels of energy deficits by manipulating energy intake and expenditure for three menstrual cycles. LH pulse frequency and triiodothyronine decreased, and 57% of women developed luteal phase defects, anovulation, and/or oligomenorrhea. An EA below 30 kcal/kg fat free mass/day increased the chance of experiencing a menstrual disturbance by 50%. However, menstrual disturbances were observed above and below that EA threshold, and changes in LH pulse frequency predicted only luteal phase defects, not oligomenorrhea or anovulation. The proposed EA threshold is not a cut-off below which menstrual disturbances occur, but represents an increased risk of experiencing menstrual disturbances. [ABSTRACT FROM AUTHOR]

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المؤلفون: Huang, Shiya, Yu, Chuyi, Hu, Min, Wen, Qidan, Wen, Xiaohui, Li, Shuna, Li, Kunyin, Ma, Hongxia

المصدر: Acupuncture in Medicine; Apr2024, Vol. 42 Issue 2, p87-99, 13p

مصطلحات موضوعية: FATTY liver prevention, GLUCOSE metabolism, LIPID metabolism, POLYCYSTIC ovary syndrome treatment, LIVER disease prevention, TESTOSTERONE, RECEIVER operating characteristic curves, HOMEOSTASIS, RESEARCH funding, DATA analysis, POLYMERASE chain reaction, KRUSKAL-Wallis Test, DIETARY fats, POLYCYSTIC ovary syndrome, CELLULAR signal transduction, DESCRIPTIVE statistics, ELECTROACUPUNCTURE, INSULIN resistance, RATS, MESSENGER RNA, GENE expression, ANIMAL experimentation, ONE-way analysis of variance, STATISTICS, LETROZOLE, PEROXISOME proliferator-activated receptors, DATA analysis software, OBESITY, ANOVULATION, TUMOR necrosis factors, INTERLEUKINS, HISTOLOGY

مصطلحات جغرافية: CHINA

مستخلص: Background: This study was designed to evaluate the effects of low-frequency electroacupuncture (EA) on glucose and lipid disturbances in a rat model of polycystic ovary syndrome (PCOS) characterized by insulin resistance (IR) and hepatic steatosis. Methods: The PCOS rat model was induced by continuous administration of letrozole (LET) combined with a high-fat diet (HFD). Female Sprague–Dawley rats were divided into the following four groups: control, control + EA, LET + HFD and LET + HFD + EA. EA was administered five or six times a week with a maximum of 20 treatment sessions. Body weight, estrous cyclicity, hormonal status, glucose and insulin tolerance, lipid profiles, liver inflammation factors, liver morphology and changes in the phosphatidylinositol 3-kinase (PI3-K)/Akt (protein kinase B) pathway were evaluated. Results: The rat model presented anovulatory cycles, increased body weight, elevated testosterone, abnormal glucose and lipid metabolism, IR, liver inflammation, hepatic steatosis and dysregulation of the insulin-mediated PI3-K/Akt signaling axis. EA reduced fasting blood glucose, fasting insulin, area under the curve for glucose, homeostasis model assessment of IR indices, triglycerides and free fatty acids, and alleviated hepatic steatosis. Furthermore, low-frequency EA downregulated mRNA expression of tumor necrosis factor (TNF)-α and interleukin (IL)-6, upregulated mRNA expression of peroxisome proliferator-activated receptor (PPAR)-α, increased protein expression of phosphorylated (p)-Akt (Ser473), p-glycogen synthase kinase (GSK) 3β (Ser9) and glucose transporter 4 (GLUT4), increased the ratio of p-GSK3β to GSK3β and downregulated protein expression of GSK3β. Conclusion: An obese PCOS rat model with IR and hepatic steatosis was successfully established by the combination of LET and HFD. EA improved dysfunctional glucose and lipid metabolism in this PCOS-IR rat model, and the molecular mechanism appeared to involve regulation of the expression of key molecules of the PI3-K/Akt insulin signaling pathway in the liver. [ABSTRACT FROM AUTHOR]

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المؤلفون: KAUR, RAMINDER, KAUR, MANINDER, SURI, VANITA

المصدر: Anthropologie; 2024, Vol. 62 Issue 1, p29-38, 10p

مصطلحات موضوعية: POLYCYSTIC ovary syndrome, HEALTH risk assessment, DISEASES in women, PHENOTYPES, ENDOCRINE diseases, METABOLIC disorders, ANOVULATION

مصطلحات جغرافية: CHANDIGARH (India)

مستخلص: Polycystic ovary syndrome is one of the escalating, but underdiagnosed hormonal disorder in women of reproductive age. The present study is an attempt to explore long term health implications in four Rotterdam the phenotypes of Polycystic ovary syndrome. For this purpose, a total of 223 PCOS women with age ranged from 18 to 45 years and living in the Chandigarh Capital Region were selected from the OPD, PGIMER, Chandigarh, (North India). Polycystic ovary syndrome among women were diagnosed as per the Rotterdam Criteria (2004). Findings of the study indicated that hirsutism (47.5%), acne (30.9%), seborrhoea (32.2%), menstrual irregularity (55.6%), and ovarian size >10 cm³ (54.7%) were most frequently encountered symptoms in women having classic PCOS phenotype as compared to women with non-PCO PCOS, non-hyperandrogenic and ovulatory PCOS phenotype. The correspondence analysis depicted that classic PCOS phenotype were more closely and significantly associated with all the symptoms of PCOS with 83.6% variance, while ovulatory PCOS depicted least association with the symptoms of PCOS indicating that oligoanovulation play a vital role in the manifestation of symptoms related to PCOS. The classic PCOS phenotype showed higher prevalence of metabolic perturbations than other phenotypes, thereby confirming classic PCOS phenotypes are at greater risk of long-term health consequences. [ABSTRACT FROM AUTHOR]

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العنوان البديل: Otolog Trombosit Açısından Zengin Plazma İntrauterin Perfüzyonu, Klomife n Sitrat Nedeniyle İnce Endometriyumu Düzelterek Doğurganlık Sonucunu İyileştirir. (Turkish)

المؤلفون: Özyurt, Ramazan, Bulutlar, Eralp, Yılmaz, Müşerref Banu

المصدر: Medical Journal of Bakirkoy; Mar2024, Vol. 20 Issue 1, p72-78, 7p

مصطلحات موضوعية: POLYCYSTIC ovary syndrome treatment, INFERTILITY treatment, OVARIAN follicle, TESTOSTERONE, ENDOMETRIUM, CLOMIPHENE, CLINICAL trials, PREGNANCY outcomes, PLATELET-rich plasma, OLIGOMENORRHEA, POLYCYSTIC ovary syndrome, ENDOSCOPIC ultrasonography, DESCRIPTIVE statistics, ESTRADIOL, SEXUAL intercourse, CATHETERS, LUTEINIZING hormone, FOLLICLE-stimulating hormone, INDUCED ovulation, ANOVULATION

الملخص (بالإنجليزية): Objective: The primary aim of this study was to investigate the effects of autologous intrauterine platelet-rich plasma (IU-PRP) infusion during ovulation induction with clomiphene citrate (CC) on endometrial thickness (EMT) and clinical pregnancy in patients with polycystic ovary syndrome (PCOS) and thin endometrium. The secondary outcome was to detect possible transformations in oligomenorrheic cycles after PRP. Methods: This study was conducted on 35 anovulatory PCOS patients aged between 22 and 29 years who applied for infertility treatment. The patients had a thin endometrium in their past history. EMT 7 mm was considered thin endometrium. The diagnosis of PCOS was made according to the revised Rotterdam criteria. A total of 35 patients were divided into two groups according to whether they received PRP or not. Twenty patients received CC plus PRP treatment, whereas 15 patients received CC treatment alone. Patients in both groups were administered CC at a dose of 100 mg/day for 5 days, starting from the 3rd day of progesterone-related withdrawal bleeding. Follicular development and EMT were recorded using transvaginal ultrasonography. In cases with EMT <7 mm, approximately 0.5-1 mL of autologous PRP was infused with the IUI catheter, four days after CC treatment, i.e., on the ninth day of the cycle. EMT was measured and recorded again 3 and 6 days after PRP. Timed intercourse was recommended for cases with a follicle with a mean diameter of at least 16-18 mm. The biochemical and clinical pregnancy rates of both groups were recorded. Results: Both groups were similar in terms of participant age and body mass index. All participants in the CC plus PRP group were successfully infused with autologous PRP on the ninth day of the cycle. The serum estradiol, testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and LH/FSH ratios of both groups were similar. Biochemical pregnancy and clinical pregnancy rates of the CC plus PRP group were significantly higher than those of the CC alone group (p<0.03 and p<0.02, respectively). Although clinical pregnancy was detected in 5 individuals in the PRP group (25%), clinical pregnancy was recorded in 2 individuals in the CC alone group (13.3%). There was no significant change in the oligo/anovulatory cycle patterns of patients with and without PRP. EMT values on the sixth (4.96±2.11 mm vs. 4.68±2.47 mm, p<0.37) and eighth days were similar between the two groups (5.11±3.10 mm vs. 5.29±3.01 mm, p<0.51). Compared with the CC alone group, the EMT values measured both at day 12 (6.34±1.09 mm vs. 5.47±3.90 mm, p<0.02) and at day 15 (7.44±2.60 mm vs. 6.23±2.70 mm, p<0.01) in the PRP group were found to be significantly higher. Conclusion: IU-PRP infusion in PCOS patients with thin endometrium who underwent ovulation stimulation with CC significantly increased both EMT and clinical pregnancy rates. [ABSTRACT FROM AUTHOR]

Abstract (Turkish): Amaç: Bu çalışmanın temel amacı ince endometriyuma sahip polikistik over sendromu (PKOS) hastalarında ovulasyon indüksiyonu sırasında klomifen sitrat (KS) ile otolog intrauterin trombositten zengin plazma (IU-PRP) infüzyonunun endometriyal kalınlık (EMT) ve klinik gebelik üzerine etkilerini araştırmaktır. İkincil sonuç, PRP sonrası oligomenoreik döngülerdeki olası dönüşümleri tespit etmektir. Gereç ve Yöntem: Bu çalışma, infertilite tedavisi için başvuran, yaşları 22-29 arasında değişen 35 anovulatuar PKOS hastası üzerinde gerçekleştirildi. Hastaların geçmiş anamnezlerinde ince endometriyum mevcuttu. Endometriyal kalınlığın 7 mm'nin altında olması ince endometriyum olarak kabul edildi. PKOS tanısı revize edilmiş Rotterdam kriterlerine göre konuldu. Toplam 35 hasta PRP alıp almamalarına göre iki gruba ayrıldı. Yirmi hastaya KS artı PRP tedavisi uygulanırken, 15 hastaya yalnızca KS tedavisi uygulandı. Her iki gruptaki hastalara progesterona bağlı çekilme kanamasının 3. gününden itibaren 5 gün süreyle 100 mg/gün dozunda KS verildi. Foliküler gelişim ve endometriyal kalınlık transvajinal ultrasonografi ile kaydedildi. Endometriyal kalınlık <7 mm olan olgulara KS tedavisinden dört gün sonra yani siklusun dokuzuncu gününde IUI kateteri ile yaklaşık 0,5-1 mL otolog PRP infüze edildi. EMT, PRP'den 3 ve 6 gün sonra tekrar ölçüldü ve kaydedildi. Ortalama çapı en az 16-18 mm olan folikül olgularında zamanlı ilişki önerildi. Her iki grubun biyokimyasal ve klinik gebelik oranları kaydedildi. Bulgular: Her iki grup da katılımcı yaşı ve vücut kitle indeksi açısından benzerdi. KS artı PRP grubundaki tüm katılımcılara döngünün dokuzuncu gününde başarıyla otolog PRP uygulandı. Her iki grubun serum östradiol, testosteron, luteinize edici hormon (LH), folikül stimülan hormon (FSH) ve LH/FSH oranları benzerdi. KS artı PRP grubunun biyokimyasal gebelik ve klinik gebelik oranları, yalnızca KS grubuna göre anlamlı derecede yüksekti (sırasıyla p<0,03 ve p<0,02). PRP grubunda 5 kişide (%25) klinik gebelik tespit edilirken, sadece KS grubunda 2 kişide (%13,3) klinik gebelik kaydedildi. PRP uygulanan ve uygulanmayan hastaların oligo/anovulatuar siklus paternlerinde anlamlı bir değişiklik olmadı. Altıncı gün (4,96±2,11 mm vs. 4,68±2,47 mm, p<0,37) ve sekizinci gündeki EMT değerleri iki grup arasında benzerdi (5,11±3,10 mm vs. 5,29±3,01 mm, p<0,51). Yalnızca KS grubuyla karşılaştırıldığında, EMT değerleri hem 12. günde (6,34±1,09 mm vs. 5,47±3,90 mm, p<0,02) hem de 15. günde (7,44±2,60 mm vs. 6,23±2,70 mm, p<0,01) PRP grubunda anlamlı olarak yüksek bulunmuştur. Sonuç: KS ile ovulasyon stimülasyonu uygulanan ince endometriyumlu PKOS hastalarında uygulanan IU-PRP infüzyonu hem endometriyal kalınlığı hem de klinik gebelik oranlarını anlamlı derecede artırmaktadır. [ABSTRACT FROM AUTHOR]

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المؤلفون: Abdulla, Mariyam Luba, Shathir, Aishath Nur, Anwaru, Shamila, Ahmed, Aminath Shiba, Ismail, Fathimath Izha, Shabin, Ahmed, Ali, Mohamed Azhadh, Subbaram, Kannan, Naher, Zeba Un, Faiz, Razana, Huda, Aminath, Manandhar, Punya Laxmi, Ali, Sheeza

المصدر: Pharmacophore; 2024, Vol. 15 Issue 2, p7-15, 9p

مصطلحات موضوعية: INDUCED ovulation, POLYCYSTIC ovary syndrome, PATHOLOGICAL physiology, ANOVULATION, CHILDBEARING age, GRANULOSA cells, NECTARIES, AVIAN influenza

مستخلص: Polycystic ovary syndrome (PCOS) is a heterogeneous endocrinopathy characterized by oligo or anovulation, hyperandrogenism, and/or polycystic ovarian morphology. While women in both developed and developing nations are affected, it is also the leading cause of ovulatory infertility among women of reproductive age. This article discusses the epidemiology, risk factors, pathophysiology, diagnosis, and particular emphasis to its treatment. Global prevalence of PCOS ranges from 4 to 21% whereas it is between 9.1 and 36% among adolescents. Clinical presentation of PCOS can be mainly attributed to hyperandrogenism and chronic anovulation. Symptoms of hyperandrogenism include hirsutism, acne, and/or male pattern alopecia. Chronic anovulation proceeds with features such as oligomenorrhea, amenorrhea, and/or infertility. Even though a specific gene responsible is not found yet, it's clear that women with PCOS have two major genetic alterations involving androgen synthesis, insulin action, and also an increased incidence of other genetic alterations. Family history, obesity, and an unhealthy diet are found to be significant risk factors for the development of PCOS. The fundamental pathological changes in PCOS include hyperandrogenism, abnormality of gonadotropin secretion, and insulin resistance. It has been noted that genes, HAS2 & CBLN1 that are associated with ovulation are expressed less in granulosa cells of PCOS patients. These cells also show significantly differentially expressed genes for transcription factors and secretory proteins in addition to having increased Toll-& NOD-like receptors. Presently, there is no universal treatment for PCOS. [ABSTRACT FROM AUTHOR]

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المؤلفون: Mostafa Khodary, Yasser Ahmed Abuelwafa Abdellatif, Mahmoud Ibrahim Almolakab B- Alrashidy, Sayed Ahmed Mohammed Taha

المصدر: SVU - International Journal of Medical Sciences, Vol 7, Iss 2, Pp 1-8 (2024)

مصطلحات موضوعية: anovulation pcos clomiphene citrate tamoxifen, metformin letrozole gonadotrophins, ovulation induction endometrium, Medicine

الوصف: Background: Polycystic ovary syndrome (PCOS) is the most prevalent cause of normogonadotrophic anovulation, also classified as World Health Organization group II anovulation. Objectives: The aim of this study was to compare the effectiveness and clinical outcomes of clomiphene citrate alone and with different combinations (metformin , tamoxifen , letrozole and low dose gonadotrophins ) in induction of ovulation in women with PCOS. Patients and methods: The Obstetrics and Gynecology department at Qena University Hospital, South Valley University, was the site of this randomized study. The study included 400 infertile cases with PCOS divided on 5 groups . The duration of the study ranged from 12-24 months. Results: In the studied groups, group 4 (clomiphene and letrozole ) and group 5 (clomiphene and low dose gonadotrophins) had the highest ovulation rate which was 31.3 % , 41.3 % respectively and also the highest pregnancy rate which was 33.8 % for each group . Conclusion: The combination of clomiphene and letrozole and clomiphene and gonadotrophins had proved to be the most effective , low cost infertility treatment in women with PCOS that offers high ovulation and pregnancy rates.

وصف الملف: electronic resource

العلاقة: https://svuijm.journals.ekb.eg/article_356800.htmlTest; https://doaj.org/toc/2735-427XTest; https://doaj.org/toc/2636-3402Test

الوصول الحر: https://doaj.org/article/3e39a76e51b44a959546dfea1f37b96dTest

المؤلفون: Incedal Irgat, Serap¹ (AUTHOR), Bakirhan, Hande² (AUTHOR)

المصدر: Human Fertility. Dec2022, Vol. 25 Issue 5, p860-871. 12p.

مصطلحات موضوعية: *OBESITY complications, *ANOVULATION, *SEMEN, *FETAL development, *SEMEN analysis, *SPERM motility, *INFERTILITY, *BODY mass index, *REPRODUCTIVE health, *DISEASE complications

مستخلص: Obesity in both women and men is regarded as one of the many factors that may contribute to impaired reproductive health. Obesity can be accompanied by several neuroendocrine and ovarian dysfunctions, including chronic oligo/anovulation, menstrual irregularities, subfertility, and the increased risk of pregnancy in women. Insulin resistance, elevated triglyceride and fatty acid levels, and the secretion of adipocytokines caused by the excessive accumulation of adipose tissue associated with obesity adversely affect reproductive functions. Alterations in sperm quality and motility and hormone levels related to a rise in body mass index (BMI) may predispose men to infertility. The mechanisms of action of obesity on male infertility include endocrinopathy, erectile dysfunction, epididymitis, increased leptin and adipocytes, increased aromatase, inflammatory cytokines secreted by fat tissue, and sperm DNA fragmentation. This study reports that an increased BMI may lead to low semen quality, poor sperm motility, and reduced fertilization rates in men as well as anovulation, pregnancy loss, diminished pregnancy, and low live birth rates in women. Having optimal weight with balanced nutrition enables one to maintain a continuity of reproductive health throughout the entire life cycle, which is extremely important in terms of having a healthy embryo, including pre-foetal life, in the continuity of pregnancy and having a live birth. [ABSTRACT FROM AUTHOR]

المؤلفون: Awoniyi O. Awonuga, Olivia G Camp, Husam M Abu-Soud

المصدر: Reproductive Biology and Endocrinology, Vol 21, Iss 1, Pp 1-15 (2023)

مصطلحات موضوعية: Polycystic ovary syndrome, Oxidative stress, Abnormal nitric oxide pulsatility, Ano and oligo-anovulation, Gynecology and obstetrics, RG1-991, Reproduction, QH471-489

الوصف: Abstract Polycystic ovary syndrome (PCOS) is a heterogeneous functional endocrine disorder associated with a low-grade, chronic inflammatory state. Patients with PCOS present an increased risk of metabolic comorbidities and often menstrual dysregulation and infertility due to anovulation and/or poor oocyte quality. Multiple mechanisms including oxidative stress and low-grade inflammation are believed to be responsible for oocyte deterioration; however, the influence of nitric oxide (NO) insufficiency in oocyte quality and ovulatory dysfunction in PCOS is still a matter for debate. Higher production of superoxide (O2 •−) mediated DNA damage and impaired antioxidant defense have been implicated as contributory factors for the development of PCOS, with reported alteration in superoxide dismutase (SOD) function, an imbalanced zinc/copper ratio, and increased catalase activity. These events may result in decreased hydrogen peroxide (H2O2) accumulation with increased lipid peroxidation events. A decrease in NO, potentially due to increased activity of NO synthase (NOS) inhibitors such as asymmetric dimethylarginine (ADMA), and imbalance in the distribution of reactive oxygen species (ROS), such as decreased H2O2 and increased O2 •−, may offset the physiological processes surrounding follicular development, oocyte maturation, and ovulation contributing to the reproductive dysfunction in patients with PCOS. Thus, this proposal aims to evaluate the specific roles of NO, oxidative stress, ROS, and enzymatic and nonenzymatic elements in the pathogenesis of PCOS ovarian dysfunction, including oligo- anovulation and oocyte quality, with the intent to inspire better application of therapeutic options. The authors believe more consideration into the specific roles of oxidative stress, ROS, and enzymatic and nonenzymatic elements may allow for a more thorough understanding of PCOS. Future efforts elaborating on the role of NO in the preoptic nucleus to determine its influence on GnRH firing and follicle-stimulating hormone/Luteinizing hormone (FSH/LH) production with ovulation would be of benefit in PCOS. Consequently, treatment with an ADMA inhibitor or NO donor may prove beneficial to PCOS patients experiencing reproductive dysfunction and infertility.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1477-7827Test

الوصول الحر: https://doaj.org/article/5c0d0ea048fe44b5a9990412dc455bc5Test

المؤلفون: Pattraporn Chera-aree, Sirikul Tanpong, Isarin Thanaboonyawat, Pitak Laokirkkiat

المصدر: BMC Women's Health, Vol 23, Iss 1, Pp 1-9 (2023)

مصطلحات موضوعية: Anovulation, Clomiphene citrate, Letrozole, Ovulation induction, Polycystic ovary syndrome, Gynecology and obstetrics, RG1-991, Public aspects of medicine, RA1-1270

الوصف: Abstract Background The aim of this study was to compare the efficacy of the combination of clomiphene citrate (CC) and letrozole to that of CC alone in inducing ovulation in infertile women with ovulatory dysfunction. Methods A randomized controlled trial was conducted at a single academic medical center between November 2020 and December 2021. Anovulatory infertility females, aged 18 to 40, were evenly distributed by a computer-generated block of four into two treatment groups. A “combination group” received a daily dose of CC (50 mg) and letrozole (2.5 mg), while a “CC-alone group” received a daily dose of CC alone (50 mg). The study medications were administered on days 3 through 7 of menstrual cycle. The primary outcome was the ovulation rate, defined by serum progesterone levels exceeding 3 ng/mL at the mid-luteal phase. The secondary outcomes were ovulation induction cycle characteristics, endometrial thickness, conception rate, and adverse events. Results One hundred women (50 per group) were enrolled in the study. The mean age was not significantly different in both groups: 31.8 years in the combination group and 32.4 years in the CC-alone groups (P = 0.54). The prevalence of polycystic ovary syndrome in the combination and CC-alone groups was 48% and 44%, respectively (P = 0.841). According to intention-to-treat analysis, the ovulation rates were 78% and 70% in the combination and CC-alone groups, respectively (P > 0.05). There was no significant difference in the mean endometrial thickness or the number of dominant follicles of the groups. No serious adverse events were observed in either group. Conclusions Our study found no significant difference between the combination of CC and letrozole and CC alone in inducing ovulation in infertile women with ovulatory dysfunction in one cycle. The small number of live births precluded any meaningful statistical analysis. Further studies are needed to validate and extend our findings beyond the scope of the current study. Trial registration The study was registered at https://www.thaiclinicaltrials.orgTest with the following number: TCTR20201108004 and was approved on 08/11/2020.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1472-6874Test

الوصول الحر: https://doaj.org/article/edbadda1bb9f45fa96f8388af48dba6dTest