Use of letrozole in assisted reproduction: a systematic review and meta-analysis.
Use of letrozole in assisted reproduction: a systematic review and meta-analysis.
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DOI：
10.1093/humupd/dmn033
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发表时间：
2008-11
影响因子：
13.3
通讯作者：
Reproductive Endocrinology Interest Group of Spanish Society of Fertility
中科院分区：
文献类型：
--
作者：
Requena A;Herrero J;Landeras J;Navarro E;Neyro JL;Salvador C;Tur R;Callejo J;Checa MA;Farré M;Espinós JJ;Fábregues F;Graña-Barcia M;Reproductive Endocrinology Interest Group of Spanish Society of Fertility
来曲唑是第三代芳香酶抑制剂（AI），在辅助生殖中应用最广泛。人工授精通过抑制雌激素的产生来诱导排卵;随后的低雌激素状态增加GnRH的释放和垂体促卵泡激素（FSH）的合成。对前瞻性和回顾性研究的文献进行了系统检索。对随机临床试验（RCT）进行了荟萃分析，以比较三种方法：来曲唑与克罗米芬（CC）、来曲唑+ FSH与FSH在宫腔内人工授精（IUI）中的作用以及来曲唑+ FSH与FSH在IVF中的作用。在没有RCT的情况下，汇总了非随机研究。9项研究被纳入荟萃分析。四项随机对照试验比较了来曲唑与CC在多囊卵巢综合征患者中的总体效果。合并结果在排卵周期（OR = 1.17; 95% CI 0.66-2.09）、每个周期的妊娠率（OR = 1.47; 95% CI 0.73-2.96）或每个患者的妊娠率（OR = 1.37; 95% CI 0.70-2.71）方面均无显著性。在3项回顾性研究中，比较了L + FSH与FSH在IUI卵巢刺激中的作用，合并OR为1.15（95% CI 0.78−1.71）。最终荟萃分析包括一项RCT和一项队列研究，比较了来曲唑+促性腺激素与促性腺激素单药治疗：每例患者的合并妊娠率无显著差异（OR = 1.40; 95% CI 0.67-2.91）。来曲唑与其他促排卵方法一样有效。进一步的随机对照研究是必要的，以更清楚地确定在人类生殖来曲唑的疗效和安全性。
Letrozole is the third-generation aromatase inhibitor (AI) most widely used in assisted reproduction. AIs induce ovulation by inhibiting estrogen production; the consequent hypoestrogenic state increases GnRH release and pituitary follicle-stimulating hormone (FSH) synthesis. A systematic search of the literature was performed for both prospective and retrospective studies. Meta-analyses of randomized clinical trials (RCTs) were performed for three comparisons: letrozole versus clomiphene citrate (CC), letrozole + FSH versus FSH in intrauterine insemination (IUI) and letrozole + FSH versus FSH in IVF. In the absence of RCTs, non-randomized studies were pooled. Nine studies were included in the meta-analysis. Four RCTs compared the overall effect of letrozole with CC in patients with polycystic ovary syndrome. The pooled result was not significant for ovulatory cycles (OR = 1.17; 95% CI 0.66–2.09), or for pregnancy rate per cycle (OR = 1.47; 95% CI 0.73–2.96) or for pregnancy rate per patient (OR = 1.37; 95% CI 0.70–2.71). In three retrospective studies which compared L + FSH with FSH in ovarian stimulation for IUI, the pooled OR was 1.15 (95% CI 0.78−1.71). A final meta-analysis included one RCT and one cohort study that compared letrozole + gonadotrophin versus gonadotrophin alone: the pooled pregnancy rate per patient was not significantly different (OR = 1.40; 95% CI 0.67–2.91). Letrozole is as effective as other methods of ovulation induction. Further randomized-controlled studies are warranted to define more clearly the efficacy and safety of letrozole in human reproduction.
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影响因子：
2.5
作者：
Hu, Y;Cortvrindt, R;Smitz, J
通讯作者：
Smitz, J
影响因子：
6.7
作者：
Casper, RF
通讯作者：
Casper, RF
影响因子：
6.7
作者：
Jee, Byung Chul;Ku, Seung Yup;Kim, Seok Hyun
通讯作者：
Kim, Seok Hyun
DOI：
10.1016/s0960-0760(01)00126-1
发表时间：
2001-12-01
影响因子：
4.1
作者：
Boeddinghaus，IM;Dowsett，M
通讯作者：
Dowsett，M
影响因子：
6.7
作者：
Gregoriou, Odysseas;Vlahos, Nikos F.;Creatsas, George K.
通讯作者：
Creatsas, George K.