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Congenital Malformations among Babies Born Following Letrozole or Clomiphene for Infertility Treatment (Oct 2014)

plos one
Title:
Congenital Malformations among Babies Born Following Letrozole or Clomiphene for Infertility Treatment
Journal:
Plos one October 01, 2014
Author(s):
Sunita Sharma, Sanghamitra Ghosh, Soma Singh, Astha Chakravarty, Ashalatha Ganesh, Shweta Rajani, B. N. Chakravarty
Author(s) affiliation:
Institute of Reprooductive Medicine, Kolkata, West Bengal, India
School of Medical Science and Technology, Indian Institute of Technology, Kharagpur, India
 

 

Short description:
Clomiphene citrate (CC) is the first line drug for ovulation induction but because of its peripheral antiestrogenic effect, letrozole was introduced as the 2nd line drug. It lacks the peripheral antiestrogenic effect and is associated with similar or even higher pregnancy rates. Since letrozole is a drug for breast cancer, its use for the purpose of ovulation induction became controversial in the light of studies indicating an increased incidence of congenital malformations.
Link to the journal
 

 

Abstract taken from PubMed

Context:
Clomiphene citrate (CC) is the first line drug for ovulation induction but because of its peripheral antiestrogenic effect, letrozole was introduced as the 2nd line drug. It lacks the peripheral antiestrogenic effect and is associated with similar or even higher pregnancy rates. Sinceletrozole is a drug for breast cancer, its use for the purpose of ovulation induction became controversial in the light of studies indicating an increased incidence of congenital malformations.
Aims:
To evaluate and compare the incidence of congenital malformations among offsprings of infertile couples who conceived naturally or withclomiphene citrate or letrozole treatment.
Setting and design:
A retrospective cohort study done at a tertiary infertility centre.
Methods and material:
A total of 623 children born to infertile women who conceived naturally or following clomiphene citrate or letrozoletreatment were included in this study. Subjects were sorted out from medical files of both mother and newborn and follow up study was done based on the information provided by parents through telephonic conversations. Babies with suspected anomaly were called and examined by specialists for the presence of major and minor congenital malformations. Other outcomes like multiple pregnancy rate and birth weight were also studied.
REsults:
Overall, congenital malformations, chromosomal abnormalities were found in 5 out of 171 (2.9%) babies in natural conception group and 5 out of 201 babies in the letrozole group (2.5%) and in 10 of 251 babies in the CC group (3.9%).
Conclusions:
There was no significant difference in the overall rate of congenital malformations among children born to mothers who conceived naturally or after letrozole or CC treatment.
Key messages:
Congenital malformations have been found to be comparable following natural conception, letrozole and clomiphene citrate. Thus, the undue fear against letrozole may be uncalled for.
Link to the paper on PubMed
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