Comparison of Clinical Outcomes in Women with Follicular Dysplasia Treated with Clomiphene Citrate and Letrozole

doi:10.12280/gjszjk.20210002

Abstract

Abstract:

Objective: To compare the clinical outcomes of artificial insemination with donor sperm (AID) in those women with follicular dysplasia who treated with clomiphene citrate (CC) and letrozole (LE).Methods: The data of AID cycles performed between January, 2012 and August, 2019 were retrospectively analyzed, including 320 cycles by women with small follicle ovulation and 286 cycles by women with follicle growth arrest or atresia. The cycles were respectively grouped according to ovulation induction protocol with CC or LE. Univariate and multivariate logical regression analyses were used to compare the intrauterine pregnancy rate (IPR) and live birth rate (LBR) between CC group and LE group. Results: Women with small follicle ovulation had a comparable IPR (27.68%vs. 21.68%, P=0.196), a significantly lower pregnancy loss rate (PLR) (10.20% vs. 29.03%, OR=0.278, P=0.038) and a significantly higher LBR (24.86% vs. 15.38%, OR=1.875, P=0.031) in the LE group when compared with CC group. Women with follicle growth arrest or atresia had a higher IPR (32.22% vs. 22.45%) without significant difference (OR=1.679, P=0.071), a comparable PLR (10.34% vs. 18.18%, OR=1.926, P=0.366) and a significantly higher LBR (28.89% vs. 18.37%, OR=1.886, P=0.035) in the CC group when compared with LE group. Conclusions: In AID procedure, LE protocol can lead to better clinical outcomes than CC for women with small follicle ovulation, while CC protocol can get better clinical outcomes than LE for women with follicle growth arrest or atresia.

Key words: Ovarian follicle, Follicular atresia, Ovulation induction, Insemination, artificial, Pregnancy rate, Live birth, Clomiphene, Letrozole

NI Li-li, WANG Jing, DIAO Fei-yang, MA Xiang, LIU Jia-yin. Comparison of Clinical Outcomes in Women with Follicular Dysplasia Treated with Clomiphene Citrate and Letrozole[J]. Journal of International Reproductive Health/Family Planning, 2021, 40(4): 277-281.

Figures/Tables 7

References 16

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组别	周期数	女方年龄（岁）	女方BMI （kg/m²）	周期序号	直径≥16 mm 卵泡数	直径≥18 mm 卵泡数	内膜厚度（mm）	精子浓度（×10⁶/mL）	PR总数（×10⁶）
CC组	143	28.13±3.11	21.20±2.55	2.02±1.01	1.50±0.70	1.25±0.48	9.19±2.08	48.89±13.32	16.31±5.68
LE组	177	27.93±3.52	22.49±3.06	2.66±1.28	1.21±0.43	1.08±0.29	9.10±1.85	47.97±11.03	15.74±4.38
t		0.515	4.037	4.956	4.284	3.767	0.420	0.677	1.007
P		0.607	<0.001	<0.001	<0.001	<0.001	0.675	0.499	0.315

组别	周期数	女方年龄（岁）	女方BMI （kg/m²）	周期序号	直径≥16 mm 卵泡数	直径≥18 mm 卵泡数	内膜厚度（mm）	精子浓度（×10⁶/mL）	PR总数（×10⁶）
CC组	143	28.13±3.11	21.20±2.55	2.02±1.01	1.50±0.70	1.25±0.48	9.19±2.08	48.89±13.32	16.31±5.68
LE组	177	27.93±3.52	22.49±3.06	2.66±1.28	1.21±0.43	1.08±0.29	9.10±1.85	47.97±11.03	15.74±4.38
t		0.515	4.037	4.956	4.284	3.767	0.420	0.677	1.007
P		0.607	<0.001	<0.001	<0.001	<0.001	0.675	0.499	0.315

组别	周期数	女方年龄（岁）	女方BMI （kg/m²）	周期序号	直径≥16 mm 卵泡数	直径≥18 mm 卵泡数	内膜厚度（mm）	精子浓度（×10⁶/mL）	PR总数（×10⁶）
CC组	90	27.12±2.79	21.48±2.59	1.94±1.15	1.42±0.62	1.18±0.42	9.06±1.90	47.76±12.51	15.73±5.51
LE组	196	27.87±3.32	21.56±2.73	2.31±1.11	1.23±0.45	1.09±0.28	9.29±1.66	48.63±11.66	16.22±5.20
t		1.850	0.245	2.570	2.658	2.095	1.052	0.577	0.730
P		0.065	0.807	0.011	0.009	0.038	0.294	0.564	0.466

组别	周期数	女方年龄（岁）	女方BMI （kg/m²）	周期序号	直径≥16 mm 卵泡数	直径≥18 mm 卵泡数	内膜厚度（mm）	精子浓度（×10⁶/mL）	PR总数（×10⁶）
CC组	90	27.12±2.79	21.48±2.59	1.94±1.15	1.42±0.62	1.18±0.42	9.06±1.90	47.76±12.51	15.73±5.51
LE组	196	27.87±3.32	21.56±2.73	2.31±1.11	1.23±0.45	1.09±0.28	9.29±1.66	48.63±11.66	16.22±5.20
t		1.850	0.245	2.570	2.658	2.095	1.052	0.577	0.730
P		0.065	0.807	0.011	0.009	0.038	0.294	0.564	0.466

组别	周期数	女方年龄（岁）	女方BMI （kg/m²）	周期序号	直径≥16 mm 卵泡数	直径≥18 mm 卵泡数	内膜厚度（mm）	精子浓度（×10⁶/mL）	PR总数（×10⁶）
宫内妊娠组	80	27.75±3.55	21.76±3.27	2.31±1.13	1.38±0.64	1.19±0.42	9.13±1.70	49.91±11.31	16.29±3.88
未获宫内妊娠组	240	28.11±3.27	21.97±2.79	2.39±1.23	1.33±0.57	1.15±0.39	9.14±2.03	47.87±12.33	15.90±5.33
t		0.831	0.536	0.507	0.660	0.813	0.035	1.311	0.708
P		0.406	0.592	0.612	0.510	0.417	0.972	0.191	0.480
活产组	66	27.70±3.47	21.73±3.30	2.35±1.13	1.38±0.65	1.18±0.43	9.11±1.72	50.56±11.26	16.43±4.05
未获活产组	254	28.10±3.30	21.96±2.81	2.38±1.23	1.33±0.57	1.15±0.39	9.14±2.01	47.81±12.26	15.88±5.22
t		0.879	0.576	0.176	0.642	0.587	0.113	1.560	0.787
P		0.380	0.565	0.860	0.521	0.557	0.910	0.100	0.432