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48A - Ultrasound Monitoring Is Not Required for Letrozole Treatment

For

from Section IX - Hormones and the Environment

Published online by Cambridge University Press:  25 November 2021

By
Ahmed Badawy
Edited by
Roy Homburg ,
Adam H. Balen  and
Robert F. Casper
Roy Homburg
Affiliation:
Homerton University Hospital, London
Adam H. Balen
Affiliation:
Leeds Centre for Reproductive Medicine
Robert F. Casper
Affiliation:
Mount Sinai Hospital, Toronto
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Summary

Aromatase enzyme is a microsomal cytochrome P450 hemoprotein-containing enzyme (the product of the CYP19 gene). It catalyzes the production of estrogens by conversion of androgens (androstenedione and testosterone) to estrone and estradiol in many tissues of the human body including the brain and ovaries. Extensive ultrasound monitoring of the letrozole-induced cycles is not required for either the number of follicles or endometrial thickness when standard dose of 2.5 or 5 mg is used based on our previous experience and many research studies, but at least minimal monitoring is mandatory for the particular group of women with PCOS especially when higher doses of letrozole are required.

Type
Chapter
Information
50 Big Debates in Reproductive Medicine , pp. 249 - 250
Publisher: Cambridge University Press
Print publication year: 2021

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References

Further Reading

Al-Omari, WR, Sulaiman, WR, Al-Hadithi, N. Comparison of two AIs in women with clomiphene-resistant polycystic ovary syndrome. Int J Gynecol Obstet. 2004;853:289–91.Google Scholar
Cole, PA, Robinson, CH. Mechanism and inhibition of cytochrome P-450 aromatase. J Med Chem. 1990;33:2933–44.CrossRefGoogle ScholarPubMed
Mitwally, MFM, Casper, RF. Use of an AI for induction of ovulation in patients with an inadequate response to clomiphene citrate. Fertil Steril. 2000;75:305–9.Google Scholar
Roberts, V, Meunier, H, Vaughan, J, et al. Production and regulation of inhibin subunits in pituitary gonadotrophs. Endocrinology. 1989;124:552–4.CrossRefGoogle Scholar
Rosenfeld, CR, Roy, T, Cox, BE. Mechanisms modulating estrogen-induced uterine vasodilation. Vascul Pharmacol. 2002;382:115–25.Google Scholar
Weil, S, Vendola, K, Zhou, J, Bondy, CA. Androgen and follicle-stimulating hormone interactions in primate ovarian follicle development. J Clin Endocrinol Metab. 1999;848:2951–6.Google Scholar

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