Evaluation of Different Doses of Letrozole in Ectopic Pregnancy

Evaluation of Different Doses of Aromatase Inhibitor Letrozole for the Treatment of Ectopic Pregnancy

The utilization of letrozole at a daily dose of 10 mg for medical treatment of ectopic pregnancy considerably has a high success rate without imposing any serious side effects compared to daily 5mg letrozole.

Letrozole, an aromatase inhibitor, has recently been introduced as favorable medical treatment for ectopic pregnancy. We aimed at evaluating the effects of different doses of letrozole for induction of abortion Sixty patients with undisturbed ectopic pregnancy were classified into three equal groups. Group I: The control group that contained women who were undergoing laparoscopic salpingectomy, Group II: Patients who received letrozole (5 mg d-1) for 10 d, and Group III: Patients who received letrozole (10 mg d-1) for 10 d. After that, the human chorionic gonadotropin (β-hCG) levels were determined for the first day and after 11 d of treating. letrozole (10 mg d-1) markedly reduced the receptors of estrogen and progesterone, and subsequent vascular endothelial growth factor signals, resulting in marked apoptosis in the placenta tissue. The utilization of letrozole at a dose of 10 mg d-1 for inducement of abortion typically results in a substantial high-successful rate without any severe side effects.

Inclusion Criteria:

• Diagnosed ectopic pregnancy was by
• Absence of an intrauterine gestational sac on vaginal ultrasound Coupled with
• β-hCG titers beyond the discrimination zone of at least 2,000 milli-International units (mIU/m).

Exclusion Criteria:

• Patients had contraindications for letrozole
• Patients with any systemic disease ( diabetes, hypertension, ....)
• Patients with b-hCG levels >3,000 mIU/mL
• Patients with hemoglobin level <10 g/dL,
• Patients with platelets count <150,000/mL,
• Patients with elevated liver enzymes,
• Patients with elevated blood urea, or serum creatinine
• The presence of a fetal heartbeat in a gestational sac detected outside the uterine cavity