Letrozole co-treatment in infertile women 40 years old and older receiving controlled ovarian stimulation and intrauterine insemination

ObjectiveTo investigate the effect of a combination of letrozole and gonadotropins in advanced reproductive age infertile women who were treated with IUI.DesignA retrospective case control study.SettingA private practice affiliated with an academic institute.Patient(s)Infertile women 40 years old and older who were treated with IUI and controlled ovarian hyperstimulation (COH) using either letrozole in combination with FSH (n = 90) or FSH alone (n = 69).Main Outcome Measure(s)Pregnancy rates (PR), mature follicles, serum levels of E2, P, LH, endometrial thickness, rates of cycle cancellation, and FSH dose.Result(s)Pregnancy rates were comparable between the letrozole–FSH co-treatment group and the FSH alone group. Significantly fewer cycles were cancelled in the letrozole co-treatment group. The E2 levels and the number of follicles were significantly higher in the FSH-only group. Serum levels of LH were significantly higher in the co-treatment group on cycle day 7. The P levels were significantly higher in the FSH alone group on the day of hCG administration.Conclusion(s)Letrozole co-treatment compared with using FSH alone has significantly modified the cycle characteristics without reducing PRs and could be of potential benefit in IUI cycles in older infertile women.