Clomiphene Citrate versus Letrozole for Ovarian Stimulation in Therapeutic Donor Sperm Insemination

Gynecol Obstet Invest. 2017;82(5):481-486. doi: 10.1159/000452665. Epub 2016 Nov 17.

Abstract

Aim: To compare clomiphene citrate (CC) and letrozole for ovarian stimulation (OS) in therapeutic donor sperm insemination (TDI) cycles.

Methods: Retrospective cohort study between January 2011 and June 2014 at a University-affiliated private IVF clinic in Montreal, Canada. 257 normo-ovulatory women ≤40 years of age with no history of infertility undergoing 590 TDI cycles in the absence of a male partner (single women and same-sex couples) or azoospermia were included. Patients received 100 mg CC daily (145 women, 321 cycles) or letrozole 5 mg daily (112 women, 269 cycles), from days 3 to 7. Only the first 3 cycles were included per patient. Our main outcome measure was cumulative live birth rates (LBR).

Results: Baseline characteristics were comparable between the 2 groups. There were no differences in LBR per cycle (16.5% (53/321) vs. 11.5% (31/269), p = 0.08) and cumulative LBR (36.6% (53/145) vs. 27.7% (31/112), p = 0.13), between CC and letrozole, respectively. Multiple pregnancy rate (11.6% (8/69) vs. 8.7% (4/46), p = 0.6) and miscarriage rate (21.7 vs. 21.7%, p = 1) were also comparable between CC and letrozole, respectively.

Conclusion: In normo-ovulatory women undergoing TDI, OS with CC or letrozole resulted in similar live birth and twin pregnancy rates.

Keywords: Clomiphene citrate; Letrozole; Live birth; Ovarian stimulation; Therapeutic donor sperm insemination.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aromatase Inhibitors
  • Canada
  • Clomiphene / administration & dosage*
  • Female
  • Fertility Agents, Female
  • Humans
  • Infertility, Male / therapy
  • Insemination, Artificial, Heterologous / methods*
  • Letrozole
  • Live Birth
  • Male
  • Nitriles / administration & dosage*
  • Ovulation Induction / methods*
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Rate
  • Retrospective Studies
  • Tissue Donors
  • Triazoles / administration & dosage*

Substances

  • Aromatase Inhibitors
  • Fertility Agents, Female
  • Nitriles
  • Triazoles
  • Clomiphene
  • Letrozole