Letrozole Compared With Clomiphene Citrate for Polycystic Ovarian Syndrome A Systematic Review and Meta-analysis

被引:18
作者
Liu, Zhuo
Geng, Yuli
Huang, Yanjing
Hu, Runan
Li, Fan
Song, Yufan [1 ,2 ]
Zhang, Mingmin [2 ]
机构
[1] Huazhong Univ Sci & Technol, Inst Integrated Tradit Chinese & Western Med, Wuhan, Peoples R China
[2] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Integrated Tradit Chinese & Western Med, Wuhan, Peoples R China
关键词
OVULATION INDUCTION; AROMATASE INHIBITOR; INFERTILE WOMEN; PREGNANCY RATE; EFFICACY;
D O I
10.1097/AOG.0000000000005070
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: To estimate the effect of letrozole and clomiphene citrate in women with infertility and polycystic ovarian syndrome (PCOS).METHODS OF STUDY SELECTION:MEDLINE through PubMed, Web of Science, EMBASE, Cochrane Library, and were searched for relevant studies from inception to February 1, 2022. Two reviewers retrieved, filtered, and extracted data independently using the bibliographic software EndNote X9 and Excel workbook. We included randomized controlled trials (RCTs) reporting ovulation induction outcomes in women with infertility and PCOS treated with either letrozole or clomiphene citrate followed by timed intercourse or intrauterine insemination. The data were merged into a mean difference or risk ratio (RR) with 95% CI, depending on variable types.TABULATION, INTEGRATION, AND RESULTS:Data collection and organization were conducted in accordance with the 2020 PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement. Twenty-nine RCTs were eligible, which included 3,952 women and 7,633 ovulation induction cycles. We acquired evidence from 22 RCTs for the ovulation rate, 28 RCTs for the clinical pregnancy rate, and eight RCTs for live-birth rate. Pooled analysis indicated that letrozole treatment prevailed against clomiphene citrate in ovulation rate (RR 1.14, 95% CI 1.06-1.21, P & lt;.001), clinical pregnancy rate (RR 1.48, 95% CI 1.34-1.63, P & lt;.001), and live-birth rate (RR 1.49, 95% CI 1.27-1.74, P & lt;.001).CONCLUSIONS:Letrozole was associated with improved ovulation, pregnancy, and live-birth rates compared with clomiphene citrate. We recommend letrozole over clomiphene citrate as an ovulation induction drug in women with infertility and PCOS, although the quality of the evidence is mixed.SYSTEMATIC REVIEW REGISTRATION:PROSPERO, CRD42022308777.
引用
收藏
页码:523 / 534
页数:12
相关论文
共 58 条
  • [1] Impact of letrozole versus clomiphene citrate on endometrial receptivity in Iraqi women with polycystic ovarian syndrome
    Al-Obaidi, Manal T.
    Ali, Zainab H.
    AL-Saadi, Wasan I.
    AL-Wasiti, Estabraq A. R.
    Al-Aubaidy, Hayder
    [J]. JOURNAL OF CLINICAL PHARMACY AND THERAPEUTICS, 2019, 44 (04) : 618 - 622
  • [2] Al-Shaikh SFMH, 2017, MIDDLE EAST FERTIL S, V22, P105, DOI 10.1016/j.mefs.2016.12.003
  • [3] Double-blind randomized controlled trial of letrozole versus clomiphene citrate in subfertile women with polycystic ovarian syndrome
    Amer, S. A.
    Smith, J.
    Mahran, A.
    Fox, P.
    Fakis, A.
    [J]. HUMAN REPRODUCTION, 2017, 32 (08) : 1631 - 1638
  • [4] Anwar A., 2016, Acta Medica Intl, V3, P88, DOI [10.5530/ami.2016.2.19, DOI 10.5530/AMI.2016.2.19]
  • [5] Comparison of letrozole and clomiphene citrate in women with polycystic ovaries undergoing ovarian stimulation
    Atay, V
    Cam, C
    Muhcu, M
    Cam, M
    Karateke, A
    [J]. JOURNAL OF INTERNATIONAL MEDICAL RESEARCH, 2006, 34 (01) : 73 - 76
  • [6] RETRACTED: Clomiphene citrate or letrozole for ovulation induction in women with polycystic ovarian syndrome: a prospective randomized trial (Retracted Article)
    Badawy, Ahmed
    Aal, Ibrahim Abdel
    Abulatta, Mohamed
    [J]. FERTILITY AND STERILITY, 2009, 92 (03) : 849 - 852
  • [7] Badawy Ahmed, 2020, Fertil Steril, V114, P669, DOI 10.1016/j.fertnstert.2020.08.1408
  • [8] Letrozole versus clomiphene citrate for ovulation induction in anovulatory women with polycystic ovarian syndrome: A randomized controlled trial
    Bansal, Shavina
    Goyal, Manu
    Sharma, Charu
    Shekhar, Shashank
    [J]. INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS, 2021, 152 (03) : 345 - 350
  • [9] Endometrial effects of letrozole and clomiphene citrate in women with polycystic ovary syndrome using spiral artery Doppler
    Baruah, Jinee
    Roy, K. K.
    Rahman, S. M.
    Kumar, Sunesh
    Sharma, J. B.
    Karmakar, Debjyoti
    [J]. ARCHIVES OF GYNECOLOGY AND OBSTETRICS, 2009, 279 (03) : 311 - 314
  • [10] Use of an aromatase inhibitor in patients with polycystic ovary syndrome:: a prospective randomized trial
    Bayar, Ulku
    Basaran, Mustafa
    Kiran, Sibel
    Coskun, Ayhan
    Gezer, Sener
    [J]. FERTILITY AND STERILITY, 2006, 86 (05) : 1447 - 1451