The Effect Of Letrozole On Physical And Mental Development In Artificial Insemination Offspring

BackgroundLetrozole as an aromatase inhibitor was introduced as an alternative treatment for ovulation in women in reproductive medicine in the past decade.Aromatase inhibitors(AIs)were originally developed for treatment of advanced breast cancer in postmenopausal women.Letrozole is effective in ovulation induction in women resistant to clomifene citrate and ovarian stimulation for intrauterine insemination and in vivo fertilization.Letrozole is an attractive option with its oral route of administration,cost,safety profile and effectiveness in ovulation induction.Letrozole led to higher live birth rates when compared with clomiphene alone.Therefore,many guideline suggest a strong recommendation based upon high-quality evidence that letrozole should be first-line pharmacological therapy to improve fertility outcomes in women with PCOS and anovulatory infertility.However,safety concerns about letrozole use in infertility were raised in even though many study presented does not increase the risk of congenital anomalies in newborns.These results need to be confirmed by future studies.Moreover,there is an urgent need for long term follow-up data among the offspring of letrozole to confirm the safety of letrozole and help subsequent guideline development.This study focus on the effect of letrozole on physical growth and mental development in artificial insemination through cohort follow-up studies of assisted reproductive technology.ObjectiveTo evaluate the long-term safety of letrozole on offspring during ovulation induction for artificial insemination,and compare the growth and mental developmental outcome in order to provide a theoretical guidance for clinical application of letrozole.MethodsWe performed a historical and prospective cohort study analysis of 126 letrozole offspring and 305 nature cycle offspring who were 0-5 year-old children from 2014.Aug to 2017 Dec.Firstly,the primary physical growth outcome included children height,weight,body mass index,head circumference and chest circumference.Secondly,age and stage questionnaire third edition(ASQ-3)was used for evaluating children mental development.Thirdly,assistant examination program included blood test,reproductive endocrine,thyroid endocrine and metabolic indicators.ResultsIn terms of physical development outcome,the results of this study showed that there was no difference in the SDS values of height,weight,body mass index,head circumference,and chest circumference between the letrozole group and the control group.In terms of mental development outcome,The results of ASQ-3 showed that the score of letrozole offspring was comparable to that of the natural cycle in the communication,coarse movements,fine movements,and problem solving.And letrozole was significantly better than the control on personal and social scores.In the assistant examination,the two groups of blood test,reproductive endocrine indicators,thyroid endocrine indicators and metabolic indicators were no significant difference.After stratified correction of the mother's polycystic ovary syndrome,the results showed that letrozole had no increase the risk of offspring physical development,mental development,and auxiliary examination indicators.ConclusionsLetrozole is relatively safe for the long-term physical and mental development of 0-5 year-old children in artificial insemination.