Comparing of letrozole versus clomiphene citrate combined with gonadotropins in intrauterine insemination cycles

Background: Clomiphene citrate (CC) an agonist and antagonist of estrogen, is the first line treatment in ovarian stimulation. Anti-estrogenic effect of CC in endometrial thickness and cervical mucus has negative effect on pregnancy rate. Letrozole is an Aromatase Inhibitor has been seen that has acceptable pregnancy rate compared to CC. Objective: The aim of this study was to compare the efficacy of letrozole and clomiphene citrate (CC) with gonadotropins for ovarian stimulation in women candidate for intrauterine insemination (IUI). Materials and Methods: One hundred sixty patients eligible to IUI therapy enrolled in this study. Patients randomized to two groups: group A (received letrozole-gonadotropin) and group B (received CC-gonadotropin). In group A (n=80) letrozole was given on days 3-7 of the menstrual cycles. In group B clomiphen citrate was given like letrozole combined with human menopausal gonadotropin (hMG) administered every day starting on day 8. Ovulation was triggered with urinary HCG when the leading follicle (s) reached 18 mm in diameter. A single IUI was performed 36-40 hours later. The ovarian stimulation response (E2 levels and number of follicles, clinical pregnancy and endometrial thickness) was primary outcome. Results: Both groups were similar in demographic characteristics. There was a significantly lower peak serum E2 level in the letrozole group compared with CC. (236±86 Vs. 283±106 pg/mL, respectively; p <0.002). The number of mature (>18 mm) preovulatory follicles was significantly higher in CC group than letrozole group (2.2±.68 Vs. 2.02±0.63 respectively; p=0.025). Endometrial thickness measured at the time of hCG administration was significantly higher in letrozole group. (9.08±1.2 mm Vs. 8.1±1.9 mm; p=0.0001). The clinical pregnancy rate was comparable between two groups. Conclusion: Letrozole is a good and cost-effective alternative to CC in IUI cycles

Relationship between general health with happiness, inferiority feeling and marital conflict in Borujerd city infertile women

AbstractBackground and aim:Nowadays, infertility and attitudes toward it, cause issues like depression, helplessness and anxiety. The present studyaimed to investigate the relationship between general health with happiness, inferiority feeling, and marital conflict ininfertile women.Methods and Materials:In this cross-sectional analytical study, 100 infertile women selected by convenience sampling. General HealthQuestionnaire (GHQ), the oxford happiness scale, inferiority feeling and Kansas Marital Conflict Scale (KMCS) wereused as data gathering tools. The Validity of the questionnaires were determined by the content and face validity. Thereliability of the questionnaires was determined using the internal consistency method. The calculated Cronbach’s alphafor general health questionnaire, happiness, inferiority feeling and the marital conflicts scale were 88%, 93%, 76%, and95% respectively. Data was analyzed using SPSS-16 software by a Pearson correlation coefficient and linear regressionResults:100 infertile women 18 - 43 years old with an average age of 29.3 were studied. 55% of women had moderate levels ofeconomic conditions and only 6% of them were referred to a psychologist or psychiatrist. The general health of thewomen with a minimum of 32 and maximum of 87 and a mean (56/14) was at moderate level. The results showed thatthere were significant relationship between general health, happiness and inferiority feeling (p &lt;0.01), while there wasno significant relationship between marital conflict and general health. Regression analysis showed that happiness andinferiority feeling with respect to the beta coefficient (-0.56, 0.21) can vary significantly predict their general health.Conclusion:General health of infertile women could be affected by the happiness and inferiority feeling. According to the results, itseems that professional assistance from psychologists and clinical psychiatrists is useful in helping infertile patients tocope better with problems caused by infertility.Keywords:Health; Happiness; Inferiority Feeling; Marital Conflict; Infertilit