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Fertility drugs given 'all-clear' in new study
April 24, 2006Concerns about the use of letrozole, an easy-to-use and inexpensive drug for the treatment of infertility, appear to be unfounded, according to a major study co-authored by Dr. Togas Tulandi, Director of Division of Reproductive Endocrinology and Infertility, McGill University Health Centre (MUHC) and Chief of Obstetrics and Gynecology at the Jewish General Hospital, and Professor of Obstetrics and Gynecology at McGill University. Their findings, which are currently available in an early online edition of Fertility and Sterility, showed that babies whose mothers were treated with letrozole had the same rate of birth defects as those whose mothers were treated with clomiphene citrate - the low-risk, first-line treatment for infertility for more than 40 years.
"We found no statistically significant difference in the overall rates of major and minor malformations or chromosomal abnormalities between newborns in the two groups," says Dr. Tulandi. "Our findings indicate concerns about a link between letrozole and birth defects are unfounded. This is significant because it confirms that letrozole can indeed be used in the treatment of infertility without increasing risk to the fetus."
The study contradicts an earlier, much smaller study linking letrozole to increased rates of inherited malformations. This study led to widespread concern about the use of letrozole, a drug which has been widely used in the treatment of infertility in recent years.
"There were several methodological problems with the earlier study," says Dr. Tulandi. "For one thing, it compared the incidence of birth defects in children conceived spontaneously with that in children conceived through fertility treatments using letrozole. This is an apples-and-oranges comparison, because there are always fewer birth defects in children conceived spontaneously." The earlier study also compared different age groups between the control and treatment.
The new study by Dr. Tulandi, Dr. Robert Casper from Department of Obstetrics and Gynecology at the University of Toronto, and their co-authors examined a total of 911 babies whose mothers were treated for infertility with either letrozole or clomiphene citrate from 2001 to 2005. Five Canadian centres in Quebec and Ontario participated.
McGill University
"There were several methodological problems with the earlier study," says Dr. Tulandi. "For one thing, it compared the incidence of birth defects in children conceived spontaneously with that in children conceived through fertility treatments using letrozole. This is an apples-and-oranges comparison, because there are always fewer birth defects in children conceived spontaneously." The earlier study also compared different age groups between the control and treatment.
The new study by Dr. Tulandi, Dr. Robert Casper from Department of Obstetrics and Gynecology at the University of Toronto, and their co-authors examined a total of 911 babies whose mothers were treated for infertility with either letrozole or clomiphene citrate from 2001 to 2005. Five Canadian centres in Quebec and Ontario participated.
McGill University
Poverty and environment billions could be wasted
Out-of-date policies are undermining unprecedented opportunities for recent aid commitments to improve the environment and combat poverty, according to scientists at a new global research centre launched today.
New fertility guidelines limit embryo transfers
The March of Dimes applauds new fertility treatment guidelines from the American Society of Reproductive Medicine (ASRM) calling for a limited number of embryos - in some cases only one - to be transferred during in-vitro fertilization procedures.
New discovery may help doctors treat infertility
New research suggests that medications commonly referred to as fertility drugs may be ineffective for women who lack a gene called the estrogen receptor beta.
Teenage hormone therapy to reduce adult height of tall girls linked to reduced fertility (p 1513)
Research from Australia in this week's issue of THE LANCET suggests that tall girls given oestrogen therapy in adolescence to reduce adult height are more likely to experience later fertility problems than the general population.
A Possible Link Between IVF And Eye Cancer? (pp 273, 309)
An observational study by Dutch authors in this week's issue of THE LANCET suggests that children conceived by in-vitro fertilisation (IVF) could be at an increased risk of retinoblastoma (a malignant tumour of the retina). However the investigators and authors of an accompanying Commentary stress that it is too early to conclude that there is a true association between IVF and retinoblastoma until larger studies can confirm these preliminary findings. Retinoblastoma is rare, occurring in around one in 17,000 births in the Netherlands and other western countries. Previous research has not identified an increased cancer risk among IVF children; however Dutch investigators led by Annette Moll
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