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Letrozole is here to stay!

July 14, 2014

letrozole for fertility


JCRM began using letrozole for fertility treatments in 2002 after it was utilized for studies with ovulation induction showing equivalent pregnancy rates and the significant reduction in injectable drugs utilized for aggressive ovulation induction cycles. The savings ranged from 1500-$3000 in drug cost alone. In our hands letrozole was far superior to clomid in many ways. Clomid has direct anti estrogen effects on tissues, including the developing egg and the endometrial lining important for implantation. Patients have had almost no side effects with this drug and many times it’s cheaper than clomid. In addition, it was much easier to take because it is taken on a single day as opposed to the 5 day therapy associated with clomid use.

In an unfortunate research snafu, a extremely poorly done study that made no statistical conclusions was presented in 2003 that suggested that letrozole increased birth defects. In its infinite wisdom and due to liability concerns, the company put a “black box” warning on the drug suggesting it caused birth defects.

Fortunately for hundreds of our patients, we were able to see through this issue clearly and realize that the study was totally meaningless and that even theoretically, letrozole couldn’t do what the authors claimed. Letrozole was never discontinued in our stimulation protocols and now we have over 10 years of experience using it. As a rule however, and as a practice, we usually do not jump to new therapies early on and are very careful to incorporate new drugs and procedures until there is very clear evidence of safety and effectiveness. The story for letrozole was exceedingly compelling and in this case we adopted it early on and weathered the information storm much to our patients benefit.

This study further validates our experience with letrozole in this large randomized study demonstrating it’s superiority over the traditional ovulation drug clomid. Our protocols are changed periodically in response to emerging information and as a group, we scour the literature for new ideas and treatments that can benefit our patients.


Read the complete article on Letrozole here

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