New Analysis Confirmsโข Letrozole Co-Management May Improve IVF Outcomes forโค Poor Responders
A systematic review and โขmeta-analysis of randomized controlled trials published in BMC Pregnancy and Childbirth suggestsโค co-administering letrozole โคwith gonadotropins during ovarian stimulation โfor in vitro fertilization (IVF) may offer benefits for patients identified as “poor responders.”โฃ However, โthe certainty of evidence varies across outcomes.
Researchers assessed the โcertainty of evidence using the GRADE approach, โfinding it ranged from moderate to very low. Evidence forโ pregnancy and live birth rates was rated as very โlow โขdue to imprecision, heterogeneity, and limited trial numbers reporting live birth data. Outcomes related to the number of retrieved oocytes and โขtransferred embryos were considered lowโค certainty, โคreflecting inconsistencies and methodological limitations across studies.
Notably, โfindings regarding reduced gonadotropin dose and shorter stimulation duration were supported by moderate-certainty evidence, demonstrating consistent effects across trialsโ despite differing protocols.
Sensitivity analysis revealed no important impactโ on the standardized meanโข difference (SMD) and its confidence interval (CI) from individual studies โor โฃclusters of studiesโ with shared characteristics, indicating robust overallโ resultsโข (fig.5). Tests for publication bias – EggerS regression, Begg’s test, โand funnel plot analysis โค- showed no evidence of bias ( *P*โ > 0.1), and the funnel plot for the โขnumber of retrievedโ oocytes appeared symmetric.