Cape Town - An anti-cancer generic drug has been proven to be more effective in treating infertility in women than traditional fertility treatment – bringing hope for a more cost-effective solution.
A study, carried out on more than 750 women with polycystic ovary syndrome, has shown that the drug letrozole improved ovulation and resulted in higher pregnancy and live birth rates compared to clomiphene. Also known as Clomid, clomiphene is traditionally used as a first-line treatment for infertility while letrozole (also known as Femara) is licensed to treat breast cancer.
The study, which has been published in the current issue of the New England Journal of Medicine, showed that women in the letrozole group had a significantly higher cumulative live birth rate at 27.5 percent compared with only 19 percent in the clomiphene-treated group.
The study – the largest to date to test the effectiveness of letrozode in fertility treatment – offers the best evidence on benefits of the generic drug, which may bring about change in clinical practice and fertility treatment.
While literature had suggested that letrozole might be beneficial in the treatment of ovulatory dysfunction, this remained debatable.
In South Africa, letrozole is registered for the treatment of early and advanced breast cancer in postmenopausal women. It has not proved effective in cancers that are not oestrogen-sensitive.
Polycystic ovary syndrome is one of the most common fertility disorders among women, affecting about 10 percent in their reproductive age.
Its symptoms include, among others, ovulation dysfunction such as irregular periods, hormone imbalance and excess androgenic (male) hormones.
Of the 750 infertile women who took part in the study, the use of clomiphene was not only associated with poor efficacy, but was also linked to a number of drawbacks, including high multiple pregnancies, mood swings and hot flushes.
On the other hand letrozole was associated with a higher rate of ovulation every month while there was also a greater chance of single pregnancies. The anti-cancer drug was however linked to higher incidences of fatigue and dizziness.
Complications of pregnancies remained similar in both treatment groups with the most common ones being gestational diabetes, eclampsia and premature birth.
The rates of pregnancy loss after conception were similar in both treatment groups.
There were also no significant differences between side effects and birth defects.
Lead researcher of the study, Dr Richard Legro, wrote that while letrozole showed superiority over clomiphene as a treatment for infertility, further studies with larger numbers of infants were needed to clarify the safety and risks that letrozole had compared to other fertility treatments.
Cape Argus