A Randomized Cohort Study: Is It Worth the Time to Receive Antiandrogenic Pretreatment Before Ovulation Induction for Women With Polycystic Ovary Syndrome?

    February 2022 in “ Frontiers in Endocrinology ”
    Zhiyan Chen, Jichun Tan, Huichun Wang, Baodong Zheng, Jian Liu, Guimin Hao, Zaixin Guo, Zhengyi Sun, Qi Yu
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    TLDR Antiandrogenic pretreatment for women with PCOS does not improve fertility outcomes and delays pregnancy.
    The study conducted in six centers across China involved 230 women with Polycystic Ovary Syndrome (PCOS) and hyperandrogenism. The participants were divided into two groups: one received immediate ovulation induction using letrozole (115 patients), and the other received antiandrogenic pretreatment using ethinylestradiol/cyproterone acetate (EE/CPA) for 3 months followed by ovulation induction using letrozole (115 patients). The final analysis included 166 participants, with 90 in the letrozole group and 76 in the EE/CPA+ letrozole group. The results showed no significant differences in cumulative ovulation, conception, ongoing pregnancy, and live birth rates between the two groups. However, the time taken to pregnancy was significantly longer in the EE/CPA+ letrozole group due to the extended 3 months of antiandrogen pretreatment. The study concluded that antiandrogenic pretreatment does not significantly improve ovulation induction outcomes but extends the time to pregnancy. Therefore, immediate ovulation induction is recommended for patients with conception plans.
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