Abstract
Research Question
Can low-dose letrozole reduce dysmenorrhea, menorrhagia, and sonographic features
in symptomatic women with adenomyosis waiting for IVF?
Design
Longitudinal randomized prospective pilot study. To explore the effectiveness of low-dose
letrozole and compare it with GnRH-agonist (GnRHa) in reducing dysmenorrhea, menorrhagia,
and sonographic features in symptomatic women with adenomyosis awaiting IVF. These
women were treated for 3 months, either with the GnRHa goserelin 3.6 mg/month (n=77),
or the aromatase inhibitor letrozole, 2.5 mg/thrice weekly (n=79). Dysmenorrhea and
menorrhagia were evaluated at randomization and followed up monthly using visual analog
score (VAS) and pictorial blood loss assessment chart (PBAC), respectively. A quantitative
scoring method was used to assess the improvement of sonographic features after three
months of treatment.
Results
Both groups reported marked improvement in symptoms after three months of treatment.
In both the letrozole and GnRHa groups, VAS and PBAC scores decreased significantly
(p<0.05) over three months of treatment. Patients on letrozole had regular menstruation
cycles, while most of the women who received GnRHa were amenorrhoeic with only 4 women
reporting mild bleeding. Hemoglobin levels and quantitative assessment of sonographic
features showed significant improvements (p<0.05) in both groups. No noticeable side
effects were observed in women receiving letrozole therapy. Additionally, letrozole
therapy was found to be more cost-effective in comparison to GnRHa treatment.
Conclusions
Low-dose letrozole treatment is a low-cost alternative to GnRHa with comparable effects
in improving symptoms and sonographic features of adenomyosis in women awaiting IVF.
Keywords
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Biography
Dr Sunita Sharma MBBS, MD (G&O), FNB is a gynaecologist and an infertility specialist at the Institute of Reproductive Medicine in Kolkata, India. Her research area of interest is female infertility with special focus on endometrial receptivity and adenomyosis and developing novel methods for pain and infertility management in adenomyosis.
Article info
Publication history
Accepted:
March 14,
2023
Received in revised form:
March 9,
2023
Received:
November 12,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
