Comparison of Letrozole and Clomiphene Citrate in Pregnancy Outcomes in Patients with Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis

被引：4

作者：

Abu-Zaid, Ahmed ^{[1
]}

Gari, Abdulrahim ^{[2
,3
]}

Sabban, Hussein ^{[4
,5
]}

Alshahrani, Majed Saeed ^{[6
]}

Khadawardi, Khalid ^{[2
]}

Badghish, Ehab ^{[7
]}

Alsghan, Rayan ^{[8
]}

Bukhari, Ibtihal Abdulaziz ^{[9
]}

Alyousef, Abdullah ^{[10
]}

Abuzaid, Mohammed ^{[11
]}

Alsharif, Saud Abdullah ^{[12
]}

Alomar, Osama ^{[13
]}

Alamery, Aliyah Hadi ^{[14
]}

Baradwan, Saeed ^{[4
]}

机构：

[1] Alfaisal Univ, Coll Med, Riyadh, Saudi Arabia

[2] Umm Al Qura Univ, Coll Med, Dept Obstet & Gynecol, Mecca, Saudi Arabia

[3] King Faisal Specialist Hosp & Res Ctr, Dept Obstet & Gynecol, Jeddah, Saudi Arabia

[4] King Faisal Specialist Hosp & Res Ctr, Dept Obstet & Gynecol, Jeddah, Saudi Arabia

[5] Najran Univ, Fac Med, Dept Obstet & Gynecol, Najran, Saudi Arabia

[6] Matern & Children Hosp, Dept Obstet & Gynecol, Mecca, Saudi Arabia

[7] Matern & Children Hosp, Dept Obstet & Gynecol, AlKharj, Saudi Arabia

[8] Princess Nourah bint Abdulrahman Univ, Coll Med, Dept Obstet & Gynecol, Riyadh, Saudi Arabia

[9] King Abdullah bin Abdulaziz Univ Hosp, Dept Obstet & Gynecol, Riyadh, Saudi Arabia

[10] Muhayil Gen Hosp, Dept Obstet & Gynecol, Muhayil, Saudi Arabia

[11] Prince Sattam bin Abdulaziz Univ, Coll Med, Dept Obstet & Gynecol, Alkharj, Saudi Arabia

[12] King Faisal Specialist Hosp & Res Ctr, Dept Obstet & Gynecol, Riyadh, Saudi Arabia

[13] Specialized Med Ctr, Dept Obstet & Gynecol, Riyadh, Saudi Arabia

[14] Almurjan Hosp, Dept Obstet & Gynecol, Jeddah, Saudi Arabia

来源：

REPRODUCTIVE SCIENCES | 2024年 / 31卷 / 04期

关键词：

Clomiphene citrate; Letrozole; Infertility; Ovulation; Pregnancy; LEUKEMIA INHIBITORY FACTOR; OVULATION INDUCTION; INFERTILE WOMEN; ENDOMETRIAL RECEPTIVITY; BREAST-CANCER; EFFICACY; PCOS; GONADOTROPINS; EXPRESSION; THICKNESS;

D O I：

10.1007/s43032-023-01404-8

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Clomiphene citrate (CC) and letrozole are the predominant medical interventions for the management of infertility in patients with polycystic ovary syndrome (PCOS). To comprehensively summarize the evidence, a systematic review and meta-analysis of randomized clinical trials (RCTs) was carried out to assess the effect of letrozole and CC on pregnancy outcomes in PCOS patients. We searched PubMed/MEDLINE, Scopus, and Cochrane Central Register of Controlled Trials from inception to January 2023. We included RCTs conducted on PCOS women comparing letrozole to CC and assessing endometrial thickness, the number and size of follicles, and ovulation and pregnancy rates. The endpoints were summarized as risk ratio (RR) or standardized mean difference (SMD) with 95% confidence interval (CI) using the random-effects model. Heterogeneity was examined using the I2 statistic. Fifty trials met our inclusion criteria. The mean endometrial thickness was significantly higher in the letrozole group compared to CC group (SMD: 0.89; 95% CI: 0.49, 1.28; I2=97.72%); however, the number of follicles was higher in the CC group (SMD: -0.56; 95% CI: -0.96, -0.17; I2=96.34%). Furthermore, letrozole intake induced higher ovulation rate (RR: 1.20; 95% CI: 1.13, 1.26; I2=54.49%) and pregnancy rate (RR: 1.44; 95% CI: 1.28, 1.62; I2=65.58%) compared to CC. Compared to CC, letrozole has a positive effect on endometrial thickness, monofollicular development, and ovulation and pregnancy rates suggesting that letrozole may be a strong alternative to CC as a first-line medical intervention for chronic anovulation in PCOS women. Larger studies are warranted to further clarify these findings.

引用

页码：883 / 905

页数：23

共 124 条

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