Letrozole boosts live birth rate in patients with PCOS undergoing FET

  • Zhang J & al.
  • Fertil Steril
  • 21 may. 2019

  • de Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • Letrozole (Femara) stimulation is associated with a higher live birth rate (LBR) compared with artificial cycle in patients with PCOS undergoing frozen-thawed embryo transfer (FET).

Why this matters

  • The best approach for endometrial preparation before FET is unclear and has been poorly studied in patients with PCOS.

Key results

  • Letrozole-stimulated cycle FET was associated with a higher ongoing pregnancy rate (aOR, 1.24; 95% CI, 1.02-1.51) and LBR (aOR, 1.33; 95% CI, 1.09-1.61) compared with artificial-cycle FET in adjusted analysis.
  • Letrozole-stimulated cycle FET was associated with a lower rate of miscarriage (aOR, 0.51; 95% CI, 0.35-0.74) compared with artificial-cycle FET in adjusted analysis.
  • Endometrial thickness was greater in the letrozole group compared with the artificial-cycle group (11.91 vs 10.10 mm; P<.001 on the day of progesterone supplementation vs mm embryo transfer>

Study design

  • 2664 patients with PCOS, 1571 who received letrozole-stimulated cycle FET and 1093 who received artificial-cycle FET, were analyzed for outcomes.
  • Funding: National Key Research and Development Program of China, National Natural Science Foundation of China, China Postdoctoral Science Foundation.

Limitations

  • Retrospective study.
  • Endometrial receptivity assay not performed on both groups of patients.