Endometrial Thinning after Ovarian Stimulation using Letrozole or Clomiphene Citrate: A Randomized Trial

Objective: To compare endometrial thickness after three consecutive cycles of ovulation induction with clomiphene citrate versus letrozole. Methods: Eighty-four women with normal menstrual interval who attended the university infertility clinic from June 2016 to March 2017 were eligible for the stu...

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Main Authors: Roungsin Choavaratana, M.D., Kitti Malakorn, M.D., Isarin Thanaboonyawat, M.D., MMedSci, Somsin Petyim, M.D., Ph.D., Pitak Laokirkkiat, M.D., Norazalina Saad, Ph.D., Japarath Prechapanich, M.D.
Format: Article
Language:English
Published: Mahidol University 2018-07-01
Series:Siriraj Medical Journal
Subjects:
Online Access:http://www.smj.si.mahidol.ac.th/sirirajmedj/index.php/smj/article/view/2647/2599
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spelling doaj-art-d7ce032f650c4fbda3564c01e41fb2862018-09-04T08:15:00ZengMahidol UniversitySiriraj Medical Journal2228-80822018-07-0170433534210.14456/smj.2018.53Endometrial Thinning after Ovarian Stimulation using Letrozole or Clomiphene Citrate: A Randomized TrialRoungsin Choavaratana, M.D.0Kitti Malakorn, M.D.1Isarin Thanaboonyawat, M.D.2MMedSci, Somsin Petyim, M.D., Ph.D.3Pitak Laokirkkiat, M.D.4Norazalina Saad, Ph.D.5Japarath Prechapanich, M.D.6Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand,Department of Obstetrics and Gynecology, Rajavithi Hospital, Bangkok, ThailandDepartment of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand,Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand,Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand,UPM-MAKNA Cancer Research Laboratory, Institute of Bioscience, University of Putra Malaysia, Serdang, Selangor, MalaysiaDepartment of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand,Objective: To compare endometrial thickness after three consecutive cycles of ovulation induction with clomiphene citrate versus letrozole. Methods: Eighty-four women with normal menstrual interval who attended the university infertility clinic from June 2016 to March 2017 were eligible for the study. After the endometrial thickness of baseline cycle was recorded, all participants were randomized into two groups of clomiphene citrate or letrozole treatment for three consecutive cycles. Endometrial thickness and estradiol level were measured when at least one follicle reached 17 mm in diameter. The differences in endometrial thickness relative to baseline of the two groups were compared. Results: A total of 62 patients completed three cycles of ovarian stimulation. Both drugs resulted in significantly thinner endometrium compared with the baseline cycle thickness. The mean endometrial thickness was significantly decreased in the clomiphene citrate group compared with letrozole group (7.46 ± 1.71 vs 8.88 ± 2.34 mm, p = 0.029). Estradiol level on the day of induced ovulation was significantly higher in the clomiphene citrate group than in the letrozole group (706.0 (207.9, 2209.0) vs 168.7 (30.0, 401.8), p < 0.001). The number of the follicles reaching 17 mm on the day of induced ovulation was higher in the clomiphene citrate group (1.9 ± 0.8 vs 1.4 ± 0.5, p = 0.002). Conclusion: Letrozole had less effect on endometrium thinning after three consecutive cycles of induced ovulation compared with clomiphene citrate.http://www.smj.si.mahidol.ac.th/sirirajmedj/index.php/smj/article/view/2647/2599Clomiphene citrate;letrozole;ovulation induction;endometrial thickness;consecutive cycles(Siriraj Med J 2018;70: 335-342)
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language English
format Article
author Roungsin Choavaratana, M.D.
Kitti Malakorn, M.D.
Isarin Thanaboonyawat, M.D.
MMedSci, Somsin Petyim, M.D., Ph.D.
Pitak Laokirkkiat, M.D.
Norazalina Saad, Ph.D.
Japarath Prechapanich, M.D.
spellingShingle Roungsin Choavaratana, M.D.
Kitti Malakorn, M.D.
Isarin Thanaboonyawat, M.D.
MMedSci, Somsin Petyim, M.D., Ph.D.
Pitak Laokirkkiat, M.D.
Norazalina Saad, Ph.D.
Japarath Prechapanich, M.D.
Endometrial Thinning after Ovarian Stimulation using Letrozole or Clomiphene Citrate: A Randomized Trial
Siriraj Medical Journal
Clomiphene citrate;
letrozole;
ovulation induction;
endometrial thickness;
consecutive cycles
(Siriraj Med J 2018;70: 335-342)
author_facet Roungsin Choavaratana, M.D.
Kitti Malakorn, M.D.
Isarin Thanaboonyawat, M.D.
MMedSci, Somsin Petyim, M.D., Ph.D.
Pitak Laokirkkiat, M.D.
Norazalina Saad, Ph.D.
Japarath Prechapanich, M.D.
author_sort Roungsin Choavaratana, M.D.
title Endometrial Thinning after Ovarian Stimulation using Letrozole or Clomiphene Citrate: A Randomized Trial
title_short Endometrial Thinning after Ovarian Stimulation using Letrozole or Clomiphene Citrate: A Randomized Trial
title_full Endometrial Thinning after Ovarian Stimulation using Letrozole or Clomiphene Citrate: A Randomized Trial
title_fullStr Endometrial Thinning after Ovarian Stimulation using Letrozole or Clomiphene Citrate: A Randomized Trial
title_full_unstemmed Endometrial Thinning after Ovarian Stimulation using Letrozole or Clomiphene Citrate: A Randomized Trial
title_sort endometrial thinning after ovarian stimulation using letrozole or clomiphene citrate: a randomized trial
publisher Mahidol University
series Siriraj Medical Journal
issn 2228-8082
publishDate 2018-07-01
description Objective: To compare endometrial thickness after three consecutive cycles of ovulation induction with clomiphene citrate versus letrozole. Methods: Eighty-four women with normal menstrual interval who attended the university infertility clinic from June 2016 to March 2017 were eligible for the study. After the endometrial thickness of baseline cycle was recorded, all participants were randomized into two groups of clomiphene citrate or letrozole treatment for three consecutive cycles. Endometrial thickness and estradiol level were measured when at least one follicle reached 17 mm in diameter. The differences in endometrial thickness relative to baseline of the two groups were compared. Results: A total of 62 patients completed three cycles of ovarian stimulation. Both drugs resulted in significantly thinner endometrium compared with the baseline cycle thickness. The mean endometrial thickness was significantly decreased in the clomiphene citrate group compared with letrozole group (7.46 ± 1.71 vs 8.88 ± 2.34 mm, p = 0.029). Estradiol level on the day of induced ovulation was significantly higher in the clomiphene citrate group than in the letrozole group (706.0 (207.9, 2209.0) vs 168.7 (30.0, 401.8), p < 0.001). The number of the follicles reaching 17 mm on the day of induced ovulation was higher in the clomiphene citrate group (1.9 ± 0.8 vs 1.4 ± 0.5, p = 0.002). Conclusion: Letrozole had less effect on endometrium thinning after three consecutive cycles of induced ovulation compared with clomiphene citrate.
topic Clomiphene citrate;
letrozole;
ovulation induction;
endometrial thickness;
consecutive cycles
(Siriraj Med J 2018;70: 335-342)
url http://www.smj.si.mahidol.ac.th/sirirajmedj/index.php/smj/article/view/2647/2599
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