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Letrozole in Fertility Therapy

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Textbook of Assisted Reproduction

Abstract

Letrozole is a third-generation aromatase inhibitor, a medication initially developed for its ability to decrease circulating estrogen levels in postmenopausal breast cancer patients. It has since been studied as an ovulation induction (OI) agent in response to the poor pregnancy rates and anti-estrogenic effects associated with clomiphene citrate. Letrozole has accumulated significant efficacy and safety data in OI and is now endorsed as first-line therapy for OI in women with PCOS by the American College of Obstetricians and Gynecologists. The Canadian Fertility and Andrology Society and the Society of Obstetricians and Gynaecologists of Canada have recently released a statement of their support for the use and safety of letrozole in ovulation induction. There is promising research with letrozole in in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) both for controlled ovulation stimulation and for use during the luteal phase of the ovarian cycle to help reduce the rates of ovarian hyperstimulation syndrome. Furthermore, letrozole may aid in increasing access to fertility treatments by decreasing the cost associated with IVF/ICSI. The use of letrozole in fertility treatments as a monotherapy and in combination therapies will be reviewed in this chapter.

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Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, BC Women’s Hospital, Vancouver, BC, Canada

    Monique Marguerie

  2. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, The University of British Columbia, Vancouver, BC, Canada

    Mohamed Bedaiwy

Authors
  1. Monique Marguerie
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  2. Mohamed Bedaiwy
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Correspondence to Mohamed Bedaiwy .

Editor information

Editors and Affiliations

  1. Consultant Reproductive Endocrinology & IVF Millennium Medical Center MMC IVF, Dubai Health Care City, Dubai, United Arab Emirates

    Gautam Nand Allahbadia

  2. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Koç University School of Medicine, Istanbul, Turkey

    Baris Ata

  3. Department of Obstetrics and Gynecology, Wright State University, Boonshoft School of Medicine, Dayton, OH, USA

    Steven R. Lindheim

  4. X&Y Fertility, Leicester, UK

    Bryan J. Woodward

  5. School of Medicine and Dentistry, University of Rochester Medical Center, Newyork, USA

    Bala Bhagavath

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Marguerie, M., Bedaiwy, M. (2020). Letrozole in Fertility Therapy. In: Allahbadia, G.N., Ata, B., Lindheim, S.R., Woodward, B.J., Bhagavath, B. (eds) Textbook of Assisted Reproduction. Springer, Singapore. https://doi.org/10.1007/978-981-15-2377-9_7

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