Table 1 Characteristics of studies included in the systematic review and meta-analysis of letrozole and OHSS after ART
Study | Type of study | Treatment | Protocol | Inclusion criteria | Usage of letrozole | Control | Standard for OHSS | Outcome |
|---|---|---|---|---|---|---|---|---|
He et al. [32] | Prospective | IVF, ICSI | Standard long protocol | No. of oocyte retrieval ≥ 25 E2 ≥ 6000 pg/ml on the HCG day Ovary diameter ≥ 10 cm Puncture follicle No. ≥ 30 | 2.5 mg qd /2.5 mg bid/2.5 mg tid, for 5 days | Oral placebo for 5 days | Golan et al | Moderate and severe |
Wang et al. [36] | Prospective | IVF | Long mid-luteal GnRH-a protocol | No. of oocyte retrieval ≥ 20 No. of follicles greater than 14 mm ≥ 20 E2 ≥ 8000 pg/ml on the HCG day Ovary diameter ≥ 10 cm | 2.5 mg p.o. Bid for 5 days | Receive no special medication | Golan et al | Mild, moderate, severe |
Mai et al. [30] | Prospective | IVF,ICSI,PGD | Midluteal long GnRH-a protocol/short GnRH-a suppressive protocol | Oocyte retrieval ≥ 25 Estradiol level ≥ 5000 pg/ml Clinical or ultrasonographic evidence of OHSS | 2.5 mg p.o. Bid for 5 days | Aspirin 100 mg qd, for 5 days | Navot D, et al | Mild, moderate, severe |
Wang et al. [35] | Prospective | IVF | Long mid-luteal GnRH-a protocol | No. of oocyte retrieval ≥ 25 No. of follicles greater than 14 mm ≥ 25 E2 ≥ 8000 pg/ml on the HCG day Ovary diameter ≥ 10 cm | Letrozole 2.5 mg p.o. Bid for 5 days + support therapy | Receive support therapy alone | Golan et al | Mild, moderate, severe |
Lin et al. [37] | Retrospective | IVF, ICSI | Long mid-luteal GnRH-a protocol | E2 ≥ 7000 pg/ml on the HCG day 7000 pg/ml > E2 ≥ 5000 pg/ml, and No. oocytes retrieval is 15 ~ 20, and abdominal distension No. of oocyte retrieval ≥ 20 | Letrozole 2.5 mg p.o. Bid for 5 days + HES + prednisone 5 mg tid | Hydroxyethyl starch(HES) + prednisone 5 mg tid | No mention | Moderate and severe |
Yu [33] | Prospective | IVF, ICSI | Long mid-luteal GnRH-a protocol | No. of oocyte retrieval > 20 E2 > 17765 pmol/l No. of follicles greater than 14 mm > 20 Ovary diameter ≥ 10 cm Other severe clinical mannifestations | Letrozole + HES + Ca | HES + Calcium gluconate (Ca) | Golan et al | Mild, Moderate, severe |
Zhang et al. [34] | Retrospective | IVF,ICSI | GnRH-a long protocol/ultra-long GnRH-a protocol | No. of oocyte retrieval ≥ 20 E2 ≥ 25620 pmol/L Obvious abdominal distension | Letrozole 2.5 mg p.o. tid for 10 days + HES | HES | Golan et al | Total OHSS, moderate and severe |
He et al. [31] | Prospective | IVF, ICSI | Standard long protocol | No. of oocyte retrieval ≥ 25 E2 ≥ 22020 pmol/l No. of follicles greater than 14 mm ≥ 30 Ovary diameter ≥ 10 cm | Letrozole 2.5 g bid, for 5 days | Placebo bid, for 5 days | Golan et al | Moderate, severe |