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• W2016196746 abstract "ObjectiveTo compare the effects of clomiphene citrate and letrozole on endometrial receptivity using immunohistochemical criteria of epithelial integrin expression in PCOS patients.DesignProspective randomized clinical study.Materials and methodsInfertile PCOS women who were randomized to clomiphene citrate(b.i.d 50 mg days 5-9, n: 8) and letrozole (2.5 mg daily, days 3-7,n: 9). All were followed by transvaginal US, LH and estradiol measurements beginning at cycle day 11. Endometrial biopsy was obtained 5 days after presumed LH peak or 3 days after documented ovulation during implantation window. Immunohistochemical staining intensity and distribution (HSCORE) of αvβ3 subunit integrins and traditional histologic endometrial dating were compared.ResultsThere were no significant differences among the groups with respect to baseline characteristics. Although both protocols produced better folliculogenesis, the changes in endometrial receptivity as determined by integrin positivity and HSCORE were higher in the letrozole protocol (integrin positivity 7 vs 4 respectively). The estradiol and progesterone levels were similar between the groups. Fourteen of the 17 endometrial samples were in-phase histologically, distributed similarly through the 2 patient groups(all advance 1-2 days). Integrin αvβ3 expression was not predicted by in-phase histology. Just as, presence of integrin was not associated with in-phase histology, neither was intensity of integrin staining as measured by the mean HSCORE (p < 0.64).ConclusionAlthough both protocols were similar in follicular recruitment in PCOS, endometrial receptivity and luteal hormonal mileu were not similarly enhanced. However, letrozole may be preferable for optimal endometrial maturation over CC in PCOS since it may lead more favourable hormonal mileu for optimal endometrial receptivity. Moreover. İt may be an alternative regimen over rFSH/HMG in IUI cycles with increased luteal hormonal/endometrial integrity. Current studies are underway to further evaluate the role of endometrial receptivity in PCOS patients undergoing letrozole stimulation with or without IUI. ObjectiveTo compare the effects of clomiphene citrate and letrozole on endometrial receptivity using immunohistochemical criteria of epithelial integrin expression in PCOS patients. To compare the effects of clomiphene citrate and letrozole on endometrial receptivity using immunohistochemical criteria of epithelial integrin expression in PCOS patients. DesignProspective randomized clinical study. Prospective randomized clinical study. Materials and methodsInfertile PCOS women who were randomized to clomiphene citrate(b.i.d 50 mg days 5-9, n: 8) and letrozole (2.5 mg daily, days 3-7,n: 9). All were followed by transvaginal US, LH and estradiol measurements beginning at cycle day 11. Endometrial biopsy was obtained 5 days after presumed LH peak or 3 days after documented ovulation during implantation window. Immunohistochemical staining intensity and distribution (HSCORE) of αvβ3 subunit integrins and traditional histologic endometrial dating were compared. Infertile PCOS women who were randomized to clomiphene citrate(b.i.d 50 mg days 5-9, n: 8) and letrozole (2.5 mg daily, days 3-7,n: 9). All were followed by transvaginal US, LH and estradiol measurements beginning at cycle day 11. Endometrial biopsy was obtained 5 days after presumed LH peak or 3 days after documented ovulation during implantation window. Immunohistochemical staining intensity and distribution (HSCORE) of αvβ3 subunit integrins and traditional histologic endometrial dating were compared. ResultsThere were no significant differences among the groups with respect to baseline characteristics. Although both protocols produced better folliculogenesis, the changes in endometrial receptivity as determined by integrin positivity and HSCORE were higher in the letrozole protocol (integrin positivity 7 vs 4 respectively). The estradiol and progesterone levels were similar between the groups. Fourteen of the 17 endometrial samples were in-phase histologically, distributed similarly through the 2 patient groups(all advance 1-2 days). Integrin αvβ3 expression was not predicted by in-phase histology. Just as, presence of integrin was not associated with in-phase histology, neither was intensity of integrin staining as measured by the mean HSCORE (p < 0.64). There were no significant differences among the groups with respect to baseline characteristics. Although both protocols produced better folliculogenesis, the changes in endometrial receptivity as determined by integrin positivity and HSCORE were higher in the letrozole protocol (integrin positivity 7 vs 4 respectively). The estradiol and progesterone levels were similar between the groups. Fourteen of the 17 endometrial samples were in-phase histologically, distributed similarly through the 2 patient groups(all advance 1-2 days). Integrin αvβ3 expression was not predicted by in-phase histology. Just as, presence of integrin was not associated with in-phase histology, neither was intensity of integrin staining as measured by the mean HSCORE (p < 0.64). ConclusionAlthough both protocols were similar in follicular recruitment in PCOS, endometrial receptivity and luteal hormonal mileu were not similarly enhanced. However, letrozole may be preferable for optimal endometrial maturation over CC in PCOS since it may lead more favourable hormonal mileu for optimal endometrial receptivity. Moreover. İt may be an alternative regimen over rFSH/HMG in IUI cycles with increased luteal hormonal/endometrial integrity. Current studies are underway to further evaluate the role of endometrial receptivity in PCOS patients undergoing letrozole stimulation with or without IUI. Although both protocols were similar in follicular recruitment in PCOS, endometrial receptivity and luteal hormonal mileu were not similarly enhanced. However, letrozole may be preferable for optimal endometrial maturation over CC in PCOS since it may lead more favourable hormonal mileu for optimal endometrial receptivity. Moreover. İt may be an alternative regimen over rFSH/HMG in IUI cycles with increased luteal hormonal/endometrial integrity. Current studies are underway to further evaluate the role of endometrial receptivity in PCOS patients undergoing letrozole stimulation with or without IUI." @default.
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• W2016196746 title "Comparing the Effects of Clomiphene Citrate and Letrozole on Endometrial Receptivity in PCOS" @default.
• W2016196746 doi "https://doi.org/10.1016/j.fertnstert.2005.07.774" @default.
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