Tolga ATAKUL, S.özlem ALTINKAYA, Gökalp ÖNER, Mahmut Tuncay ÖZGÜN, Yılmaz ŞAHİN, Ercan Mustafa AYGEN

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

Amaç: Bu çalışmada letrozol ve gonadotropinlerin evre 1-2 endometriozisli infertil hastalarda ovülasyon indüksiyonu üzerine etkilerinin karşılaştırılması amaçlanmıştır.Gereç ve yöntem: Prospektif randomize olarak dizayn edilen çalışmaya tanısal laparoskopi yapılan ve histolojik olarak tanı konulan evre 1-2 endometriozisli 20 hasta dahil edildi. Zamanlanmış cinsel ilişki ile devam etmeyi planlayan hastalar, en az üç en fazla beş ovulasyon indüksiyonu döngüsü için letrozol (n=10) veya gonadotropinler (n=10) olmak üzere iki tedavi grubuna ardışık olarak randomize edildi.Bulgular: Ovulasyon, letrozol grubunda %82,2 (37/45 siklus) ve gonadotropin grubunda %86,4 (32/37 siklus) oranlarında gerçekleşti. İki grup arasında ovulasyon oranları istatistiksel olarak benzerdi (p=0,590). hCG uygulamasının yapıldığı gün gonadotropin grubunda toplam folikül sayısı anlamlı olarak yüksekti (2,33±0,71 ve 3,05±0,91, p<0,001). Klinik gebelik oranları hem tamamlanmış siklus başına hem de hasta başına iki grup arasında benzerdi (sırasıyla siklus başına %8,1 ve %9,4 p=0,850 ve hasta başına %30 ve%30, p=1,000). Sonuç: Letrozol iyi tolere edilebilen bir ovulasyon indüksiyonu ajanıdır. Evre 1-2 Endometriozisli hastalarda letrozolün ovülasyon indüksiyonu üzerindeki etkileri gonadotropinlerle karşılaştırılabilir bulunmuştur.

Anahtar Kelimeler:

etrozol, gonadotropin, endometriozis

Letrozole versus gonadotropins for ovulation induction in patients with endometriosis: a prospective randomized trial

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:

Letrozole, gonadotropin, endometriosis,

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