RESUMO
Objective: the aim of this study was to see the effect of adding aromatase inhibitor, letrozole to a high doses of rFSH/hMG-antagonist regimen on the number of the mature follicles, retrieved oocytes, egg's quality, clinical pregnancy rate, and rate of cycle cancellation in poor responder patients with a previous history of at least 2 cancelled IVF cycles
Study Design: this study included 83 infertile couples who had at least two cancelled IVF trials due to poor ovarian response. Those patients were divided into two groups, letrozole group, included 41 infertile couples, and control group included 43 infertile couples, and compared
Results: patients.in both groups were comparable in terms of age [37.3 +/- 1.2 versus 35.7 +/- 2.4 years], .day 3 FSH, LH, and E2 serum levels as shown in table 1. There was no significant differences among both groups regarding the number of stimulation days [10.3 +/- 0.6 versus 9.6 +/- 0.4], mean FSH/hMG dose administered [4,236 +/- 219 versus 4,463 +/- 238], and endometrial thickness [8.6 +/- 1.3 versus 9.8 +/- 0.9]. However, there were significant differences between both groups in terms of cancellation rate due to poor response [12.2% versus 34.9, p < 0.001], number of mature follicles [5.8 +/- 1.2 versus 3.4 +/- 0.6, p = 0.039], and in the number of retrieved oocytes [8.3 +/- 1.6 versus 4.2 +/- 0.6, p < 0.001]. In addition, there were significant differences in the terms of fertilization rate [86.4% versus 64.9%, p = 0.038], and in the clinical pregnancy rate [44.4% versus 25%, p = 0.36] between the two groups, however, there is no significant difference between them regarding the percentage of the multiple pregnancies [25% versus 28.6%, p = 0.43]
Conclusion: in conclusion, addition of aromatase inhibitors, letrozole in the first 10 days of the stimulation induction using a high doses of rFSH/hMG antagonist regimen, were associated with a higher number of mature follicles, less cancellation rate, more retrieved mature oocytes, and higher clinical· pregnancy rate in low responder patients with a previous history of at least 2 cancelled IVF cycles