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We have been exclusively using Letrozole since 2001.

July 2, 2015

Dr. Fox responds to the following article:
http://www.obgynnews.com/specialty-focus/gynecology/single-article-page/letrozole-bests-clomiphene-again-in-infertile-women-with-pcos/8204d5f890bf11e083309547e9bccca7.html
At JCRM & Advanced Reproductive Specialists, we have been exclusively using Letrozole since 2001. Clomiphene or Clomid has many negative estrogenic effects that cause side effects of hot flashes, mood changes, and headaches, but more importantly result in lower than expected pregnancy rates. We continued to use Letrozole even during the dark times where there was great controversy over its use. A study came out in 2003 that tried to show that there were increased birth defects with the use of Letrozole. The problem was that there were far too few patients in the study to draw any conclusions and the comparison populations were completely mismatched. New information quickly was presented that refuted the initial claim and showed if anything that Clomid had a higher rate of birth defects than Letrozole, but fear had already spread through the system. Surprisingly, of the two drugs, Clomid is the one that is still in a woman’s system at the time of conception. For all these reasons including the obvious better pregnancy rates, we and others continued to use Letrozole.
As a result, we have vast experience with the use of Letrozole, and have learned its nuances through the years. It is different in the characteristics and timing of the cycle from the old Clomid cycle. There are older studies that show with Clomid use in normal ovulatory women that the pregnancy rate is actually reduced slightly. With this and other evidence through the years, Letrozole should be first line therapy for any oral ovulation induction cycles.
Dr. Fox
Michael D. Fox, MD
Jacksonville Center
Reproductive Medicine
jcrm.org

   
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