排卵藥比較: Clomiphene vs. letrozole

排卵藥比較: Clomiphene vs. letrozole
Letrozole 比Clomiphene可能較可提高子宮內膜接受度之相關物質(LIF, DKK1, LIFR, FGF-22)之基因表現

from: http://www.ncbi.nlm.nih.gov/pubmed?term=Wallace%20KL%2C%20Johnson%20V%2C%20Sopelak%20V%2C%20Hines%20R

Fertil Steril. 2011 Oct;96(4):1051-6.

Clomiphene citrate versus letrozole: molecular analysis of the endometrium in women with polycystic ovary syndrome.

Wallace KL, Johnson V, Sopelak V, Hines R.

Source

Department of Obstetrics & Gynecology, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA. kwallace2@umc.edu

Abstract

OBJECTIVE:

To compare the effect of clomiphene citrate (CC) and letrozole on endometrial receptivity in women with polycystic ovary syndrome (PCOS).

DESIGN:

A randomized controlled trial.

SETTING:

University teaching hospital.

PATIENT(S):

Ten anovulatory women with PCOS and 5 fertile ovulatory women.

INTERVENTION(S):

Patients received 2.5 mg of letrozole on cycle days 3-7 (5 patients, 1 cycle) or 50 mg of CC on cycle days 5-9 (5 patients, 1 cycle).

MAIN OUTCOME MEASURE(S):

Serum estrogen (E) and progesterone (P) endometrial protein and messenger RNA (mRNA) expression of leukemia inhibitory factor (LIF), dickkhopf homolog 1 (DKK-1), fibroblast growth factor 22 (FGF-22), and endometrial mRNA expression of LIF/GP130 receptor (LIFR).

RESULT(S):

No statistically significant differences were observed between groups compared with fertile ovulatory women when serum E and P were examined, or between body mass index (BMI), and cycle day at time of biopsy. Letrozole increased mRNA expression of LIF, DKK1, LIFR, and FGF-22, whereas CC only increased endometrial mRNA expression of LIF. Letrozole mRNA expression directly translated into increased protein expression of like genes in the endometrium. The CC protein expression of DKK-1 was significantly decreased compared with controls.

CONCLUSION(S):

Letrozole positively influences a number of markers of endometrial receptivity compared with CC.