Endometriozisli hastalarda ovulasyon indüksiyonu ajanı olarak letrozol ve gonedotropinlerin karşılaştırılması: prospektif randomize çalışma

Tolga Atakul, Sündüz Özlem Altınkaya, Gökalp Öner, Mahmut Tuncay Özgün, Yılmaz Şahin, Ercan Aygen
In: Pamukkale Medical Journal · 2020 · doi:10.31362/patd.548470 · W2997430546
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Letrozole and gonadotropins showed comparable ovulation and clinical pregnancy rates for women with stage 1-2 endometriosis, with letrozole being well-tolerated and cost-effective.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This prospective randomized trial compared letrozole versus gonadotropins as ovulation-induction agents in 20 infertile patients with histologically confirmed stage 1–2 endometriosis undergoing diagnostic laparoscopy, over 3–5 timed treatment cycles. Ovulation occurred at a similar frequency in the letrozole group (82.2%) and the gonadotropin group (86.4%), with no statistically significant difference, and clinical pregnancy rates per completed cycles and per patient were also similar. A higher total follicle count was observed in the gonadotropin group on the day of hCG administration, despite comparable outcomes overall. A key limitation is the small sample size and short, cycle-limited study duration (minimum three, maximum five cycles) with only 20 participants. This paper is centrally about endometriosis — it directly tests letrozole versus gonadotropins for ovulation induction in stage 1–2 endometriosis.

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Abstract

Purpose: This study aimed to compare the effects of letrozole and gonadotropins for ovulation induction in infertile patients with stage 1-2 endometriosis. Materials and methods: Twenty patients who underwent diagnostic laparoscopy and histologically diagnosed stage 1-2 endometriosis were included in this prospective randomized study. Patients who planned to continue with timed sexual intercourse were randomized into two treatment groups including letrozole (n=10) or gonadotropins (n=10) for minimum three and maximum five treatment cycles. Results: Ovulation occurred in 37/45 cycles (82.2%) in the letrozole group and 32/37 cycles (86.4%) in the gonadotropin group, without statistically significant difference ( p =0.590). Total number of follicles was significantly higher in gonadotropin group on the day of hCG administration (2.33±0.71 vs. 3.05±0.91, p < 0.001). Clinical pregnancy rates both per completed cycles and per patients were similar between two groups (8.1% vs. 9.4%, p =0.850 and 30% vs. 30%, p =1.000; respectively). Conclusions: Letrozole is well tolerated and cost effective ovulation induction agent in patients with endometriosis and effects of letrozole for ovulation induction were comparable to gonadotropins.
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Abstract

Purpose: This study aimed to compare the effects of letrozole and gonadotropins for ovulation induction in infertile patients with stage 1-2 endometriosis.

Materials and methods

Twenty patients who underwent diagnostic laparoscopy and histologically diagnosed stage 1-2 endometriosis were included in this prospective randomized study. Patients who planned to continue with timed sexual intercourse were randomized into two treatment groups including letrozole (n=10) or gonadotropins (n=10) for minimum three and maximum five treatment cycles.

Results

Ovulation occurred in 37/45 cycles (82.2%) in the letrozole group and 32/37 cycles (86.4%) in the gonadotropin group, without statistically significant difference (p=0.590). Total number of follicles was significantly higher in gonadotropin group on the day of hCG administration (2.33±0.71 vs. 3.05±0.91, p<0.001). Clinical pregnancy rates both per completed cycles and per patients were similar between two groups (8.1% vs. 9.4%, p=0.850 and 30% vs. 30%, p=1.000; respectively).

Conclusions

Letrozole is well tolerated and cost effective ovulation induction agent in patients with endometriosis and effects of letrozole for ovulation induction were comparable to gonadotropins.

Keywords

References - [1] Greene AD, Lang SA, Kendziorski JA, Sroga-Rios JM, Herzog TJ, Burns KA. Endometriosis: where are we and where are we going? Reproduction. 2016;152(3):R63-https://dx.doi.org/ 10.1530/REP-16-0052. - [2] Kiesel L, Sourouni M. Diagnosis of endometriosis in the 21st century. Climacteric. 2019:1-7.https://dx.doi.org/10.1080/13697137.2019.1578743. [Epub ahead of print] - [3] Eskenazi B, Warner ML. Epidemiology of endometriosis. Obstetrics &Gynecology Clinics of North America. 1997; 24: 235–258. - [4] Guzick DS. Clinical epidemiology of endometriosis and infertility. Obstetrics and Gynecology Clinics of North America 1989; 16: 43–59. - [5] Practice Committee of the American Society for Reproductive Medicine. Endometriosis and infertility: a committee opinion. Fertil Steril. 2012;98(3):591-8. - [6] Barbieri RL. Endometriosis 1990. Current treatment approaches. Drugs 1990; 39: 502–511. - [7] Fisch P, Casper RF, Brown SE et al. Unexplained infertility: evaluation of treatment with clomiphene citrate and human chorionic gonadotropin. Fertil Steril 1989; 51: 828 –833. - [8] Ailawadi RK, Jobanputra S, Kataria M, Gurates B, Bulun SE. Treatment of endometriosis and chronic pelvic pain with letrozole and norethindrone acetate: a pilot study. Fertil Steril. 2004; 8: 290-296. Details Primary Language English Subjects Obstetrics and Gynaecology Journal Section Research Article Authors Tolga Atakul 0000-0002-0219-000X Türkiye Gökalp Öner This is me 0000-0002-6270-4340 Türkiye Mahmut Tuncay Özgün This is me 0000-0003-4946-2268 Türkiye Yılmaz Şahin This is me 0000-0002-3415-8151 Türkiye Ercan Mustafa Aygen This is me 0000-0002-8677-0940 Türkiye Publication Date January 21, 2020 Submission Date April 2, 2019 Acceptance Date January 3, 2020 Published in Issue Year 2020 Volume: 13 Number: 1

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