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Comparison of the Effect of Clomiphene citrate and Letrozole on the corpus luteum and perifolliculer Blood flow Measured by Coloured and pulsed Doppler sonography
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| Author:
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DALIA JASIM MAHMOOD, WASAN ADNAN ABDULHAMEED, HUDA ALI HUSSAINI
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| Abstract:
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Background: It has long been recognized that neovascularization may be of prime importance in the growth and selection of ovulatory follicles, in addition to the subsequent development and function of the corpus luteum. luteal blood flow was significantly lower in women with luteal phase defect than in women with normal luteal function, suggesting that low blood flow of the corpus luteum is associated with luteal phase defect.
Objective: to decide which induce better perifolliculer and corpus luteum Blood flow either clomiphene citrate or Letrozole in IUI patient.
Subject, Materials and Method: Fifty infertile female patients who had undergone IUI procedure were classified into two groups ,they received standard dose of either clomiphene citrate or letrozole as induction protocol for one cycle. On cycle day 11, 12 or 13 ultrasound done to examine growth of follicle and also Doppler study done to measure perifolliculer blood flow and endometrial thickness at the same time blood sample to measure vascular endothelial growth factor and estradiol and progesteron levels were taken. At day of IUI Procedure Doppler study done to examine Corpus luteum blood flow andfollow up the patient to do pregnancy test after two weeks.
Results, there were significant differences between clomiphene citrate and letrozole groups in the number of dominant follicles (p =0.043), endometrial thickness at HCG trigger(6.45 ± 0.77, 8.46 ± 0.87) and VEGF level (p < 0.001) .The Perifollicular and Corpus luteum doppler blood flow between the study groups had been shown .There was significant differences in Perifollicular RI , Corpus luteum RI and Corpus luteum PI (p< 0.001) but there was no significant differences in Perifollicular PI (p=0.476).
The number of pregnancies achieved in letrozole group was (32%) and in clomiphene citrate group (20%) although non-significant difference.
Conclusion: Perifollicular resistance index (RI) and Corpus luteum resistance index and pulsatility index was significantly lower in letrozole group compared to clomiphene group and letrozole group had a higher pregnancy rate compared to clomiphene citrate group with 32% and 20% respectively although not significant .
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| Keyword:
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Corpus luteum blood flow, Colored and pulsed Doppler, clomiphene citrate, letrozole.
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2020.SP1.266
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| Download:
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