Letrozole co-treatment in infertile women 40 years old and older receiving controlled ovarian stimulation and intrauterine insemination

OBJECTIVE: To investigate the effect of a combination of letrozole and gonadotropins in advanced reproductive age infertile women who were treated with IUI. DESIGN: A retrospective case control study. SETTING: A private practice affiliated with an academic institute. PATIENT(S): Infertile women 40 years old and older who were treated with IUI and controlled ovarian hyperstimulation (COH) using either letrozole in combination with FSH (n = 90) or FSH alone (n = 69). MAIN OUTCOME MEASURE(S): Pregnancy rates (PR), mature follicles, serum levels of E(2), P, LH, endometrial thickness, rates of cycle cancellation, and FSH dose. RESULT(S): Pregnancy rates were comparable between the letrozole-FSH co-treatment group and the FSH alone group. Significantly fewer cycles were cancelled in the letrozole co-treatment group. The E(2) levels and the number of follicles were significantly higher in the FSH-only group. Serum levels of LH were significantly higher in the co-treatment group on cycle day 7. The P levels were significantly higher in the FSH alone group on the day of hCG administration. CONCLUSION(S): Letrozole co-treatment compared with using FSH alone has significantly modified the cycle characteristics without reducing PRs and could be of potential benefit in IUI cycles in older infertile women.