期刊
FRONTIERS IN ENDOCRINOLOGY
卷 13, 期 -, 页码 -出版社
FRONTIERS MEDIA SA
DOI: 10.3389/fendo.2022.813188
关键词
combined oral contraceptives; hyperandrogenism; ovulation induction; polycystic ovary syndrome; pregnancy outcomes
The use of combined oral contraceptives (COCs) as antiandrogenic pretreatment before ovulation induction in PCOS patients with hyperandrogenism did not show superior results in terms of ovulation and pregnancy outcomes compared to direct letrozole-induced ovulation therapy. Performing antiandrogenic therapy before ovulation induction in patients with PCOS does not provide any benefit in clinical practice.
ObjectiveTo assess the effect of antiandrogenic pretreatment using combined oral contraceptives (COCs) before ovulation induction in infertile patients with polycystic ovary syndrome (PCOS) with hyperandrogenism. DesignProspective, randomized open-labeled cohort study SettingMulticenter PatientsPCOS patients with hyperandrogenism and requiring infertility treatments InterventionsRandomization to direct ovulation induction of letrozole (letrozole group) or ethinylestradiol/cyproterone acetate (EE/CPA) for 3 months and subsequent letrozole-induced ovulation (EE/CPA+ letrozole group). The maximum number of ovulation induction cycle was three to four. Main Outcome MeasuresOvulation rate, conception rate, ongoing pregnancy rate, and live birth rate were the main outcomes of the study. ResultsThere were no significant differences in the cumulative ovulation, conception, ongoing pregnancy, and live birth rates between the letrozole and EE/CPA+ letrozole groups (cumulative ovulation: 206/254 [81.10%] vs. 169/205 [82.44%], risk ratio [RR]= 1.09 [0.68,1.76], P=0.713; conception: 44/90 [48.89%] vs. 42/76 [55.26%], RR= 1.29 [0.70,2.38], P=0.413; ongoing pregnancy: 33/90 [36.67%] vs. 33/76 [43.42%], RR=1.33 [0.71,2.47], P=0.376; and live birth: 32/90 [35.56%] vs. 31/76 [40.79%], RR=1.25 [0.67, 2.34], P=0.489). ConclusionsThe results of this study showed that COC pretreatment was not superior to direct letrozole-induced ovulation therapy in improving ovulation and pregnancy results in women with PCOS. There is no benefit to perform antiandrogenic therapy before ovulation induction in patients with PCOS in clinical practice.
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