2020
Endometrial thickness after ovarian stimulation with gonadotropin, clomiphene, or letrozole for unexplained infertility, and association with treatment outcomes
Quaas AM, Gavrizi SZ, Peck JD, Diamond MP, Legro RS, Robinson RD, Casson P, Christman GM, Zhang H, Hansen KR, Network E. Endometrial thickness after ovarian stimulation with gonadotropin, clomiphene, or letrozole for unexplained infertility, and association with treatment outcomes. Fertility And Sterility 2020, 115: 213-220. PMID: 32972733, PMCID: PMC7796980, DOI: 10.1016/j.fertnstert.2020.07.030.Peer-Reviewed Original ResearchConceptsLive birth rateEndometrial thicknessUnexplained infertilityOvarian stimulationRisk ratioLive birthsEMT groupHuman chorionic gonadotropin administrationHigher live birth rateIntrauterine insemination treatmentMean endometrial thicknessMultiple Intrauterine GestationsOvarian stimulation medicationChorionic gonadotropin administrationProspective cohort analysisUnadjusted risk ratioAdjusted risk ratioBirth rateOS-IUIThin endometriumIntrauterine gestationGonadotropin administrationStimulation medicationsClinical trialsTreatment outcomes
2019
First-line ovulation induction for polycystic ovary syndrome: an individual participant data meta-analysis
Wang R, Li W, Bordewijk E, Legro R, Zhang H, Wu X, Gao J, Morin-Papunen L, Homburg R, König T, Moll E, Kar S, Huang W, Johnson N, Amer S, Vegetti W, Palomba S, Falbo A, Özmen Ü, Nazik H, Williams C, Federica G, Lord J, Sahin Y, Bhattacharya S, Norman R, van Wely M, Mol B, Network+ R, Collaboration T. First-line ovulation induction for polycystic ovary syndrome: an individual participant data meta-analysis. Human Reproduction Update 2019, 25: 717-732. PMID: 31647106, DOI: 10.1093/humupd/dmz029.Peer-Reviewed Original ResearchConceptsPolycystic ovary syndromeClinical pregnancy rateClomiphene citrateLive birth rateOvulation inductionTime-to-pregnancyAnovulatory infertilityFrequent cause of anovulatory infertilityPregnancy rateCause of anovulatory infertilityBirth rateMetformin to CCOvulation induction agentsIncreased clinical pregnancyLive birthsPrimary randomised controlled trialsClinical pregnancyRandomised controlled trialsInfertilityIndividual participant dataIPD meta-analysesWomenPositive interactionsLetrozoleAccurate assessment of outcomes
2017
Effect of Acupuncture and Clomiphene in Chinese Women With Polycystic Ovary Syndrome: A Randomized Clinical Trial
Wu XK, Stener-Victorin E, Kuang HY, Ma HL, Gao JS, Xie LZ, Hou LH, Hu ZX, Shao XG, Ge J, Zhang JF, Xue HY, Xu XF, Liang RN, Ma HX, Yang HW, Li WL, Huang DM, Sun Y, Hao CF, Du SM, Yang ZW, Wang X, Yan Y, Chen XH, Fu P, Ding CF, Gao YQ, Zhou ZM, Wang CC, Wu TX, Liu JP, Ng EHY, Legro RS, Zhang H. Effect of Acupuncture and Clomiphene in Chinese Women With Polycystic Ovary Syndrome: A Randomized Clinical Trial. JAMA 2017, 317: 2502-2514. PMID: 28655015, PMCID: PMC5815063, DOI: 10.1001/jama.2017.7217.Peer-Reviewed Original ResearchConceptsPolycystic ovary syndromeControl acupunctureActive acupunctureOvary syndromeLive birthsChinese womenClomiphene groupAcupuncture groupPlacebo groupLow-frequency electrical stimulationActive acupuncture groupControl acupuncture groupSuperficial needle insertionEffect of acupunctureLive birth rateUse of acupunctureMonths of pregnancyNeedle insertionRandomized womenAdverse eventsSecondary outcomesPrimary outcomeClinical evidenceClinical trialsInfertility treatment
2016
Vitamin D Status Relates to Reproductive Outcome in Women With Polycystic Ovary Syndrome: Secondary Analysis of a Multicenter Randomized Controlled Trial
Pal L, Zhang H, Williams J, Santoro NF, Diamond MP, Schlaff WD, Coutifaris C, Carson SA, Steinkampf MP, Carr BR, McGovern PG, Cataldo NA, Gosman GG, Nestler JE, Myers E, Legro RS, Network F. Vitamin D Status Relates to Reproductive Outcome in Women With Polycystic Ovary Syndrome: Secondary Analysis of a Multicenter Randomized Controlled Trial. The Journal Of Clinical Endocrinology & Metabolism 2016, 101: 3027-3035. PMID: 27186859, PMCID: PMC4971341, DOI: 10.1210/jc.2015-4352.Peer-Reviewed Original ResearchConceptsPolycystic ovary syndromeLive birthsVitD statusOvary syndromeSerum 25OHDIndependent predictorsSecondary analysisOvulation induction outcomesSerum 25OHD levelsVitamin D statusHealth diagnostic criteriaD statusNonpregnant populationRetrospective cohortControlled TrialsVitamin DPregnancy lossReproductive outcomesDiagnostic criteriaTrial dataProgressive improvementWomenInduction outcomeNational InstituteSyndromeBenefit of Delayed Fertility Therapy With Preconception Weight Loss Over Immediate Therapy in Obese Women With PCOS
Legro RS, Dodson WC, Kunselman AR, Stetter CM, Kris-Etherton PM, Williams NI, Gnatuk CL, Estes SJ, Allison KC, Sarwer DB, Diamond MP, Schlaff WD, Casson PR, Christman GM, Barnhart KT, Bates GW, Usadi R, Lucidi S, Baker V, Zhang H, Eisenberg E, Coutifaris C, Dokras A. Benefit of Delayed Fertility Therapy With Preconception Weight Loss Over Immediate Therapy in Obese Women With PCOS. The Journal Of Clinical Endocrinology & Metabolism 2016, 101: 2658-2666. PMID: 27172435, PMCID: PMC4929837, DOI: 10.1210/jc.2016-1659.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAnti-Obesity AgentsBehavior TherapyClomipheneCombined Modality TherapyContraceptives, Oral, HormonalFemaleFertility Agents, FemaleHumansInfertility, FemaleLife StyleObesityPolycystic Ovary SyndromePreconception CarePregnancyPregnancy RateReproductive Techniques, AssistedTime FactorsWeight LossYoung AdultConceptsPolycystic ovary syndromeImmediate treatmentLifestyle modificationObese womenOral contraceptivesInfertility treatmentPolycystic Ovary Syndrome trialCumulative live birth rateOvulation rateWeight lossContinuous oral contraceptivesCumulative ovulation rateCycles of clomipheneOral contraceptive pretreatmentPreconception weight lossLive birth rateOverweight/obeseConcurrent clinical trialsYears of ageBirth rateImproved ovulationPPCOS IIPreconception treatmentClomiphene citrateII trial
2015
Letrozole, Gonadotropin, or Clomiphene for Unexplained Infertility
Diamond MP, Legro RS, Coutifaris C, Alvero R, Robinson RD, Casson P, Christman GM, Ager J, Huang H, Hansen KR, Baker V, Usadi R, Seungdamrong A, Bates GW, Rosen RM, Haisenleder D, Krawetz SA, Barnhart K, Trussell JC, Ohl D, Jin Y, Santoro N, Eisenberg E, Zhang H. Letrozole, Gonadotropin, or Clomiphene for Unexplained Infertility. New England Journal Of Medicine 2015, 373: 1230-1240. PMID: 26398071, PMCID: PMC4739644, DOI: 10.1056/nejmoa1414827.Peer-Reviewed Original ResearchConceptsUnexplained infertilityMultiple gestationsOvarian stimulationClinical pregnancyStandard therapyLive birth ratePatent fallopian tubesMultiple gestation ratesYears of ageFetal heart activityLetrozole groupNeonatal complicationsClomiphene citrateTriplet gestationsOngoing pregnancyPrimary outcomeGonadotropin treatmentFallopian tubeGestation rateCongenital anomaliesPregnancy rateWomen 18Live birthsClomipheneLetrozolePredictors of participant retention in infertility treatment trials
Kuang H, Jin S, Thomas T, Engmann L, Hansen KR, Coutifaris C, Casson P, Christman G, Alvero R, Santoro N, Eisenberg E, Diamond MP, Legro RS, Zhang H, Network R, Bartlebaugh C, Dodson W, Estes S, Gnatuk C, Ladda R, Ober J, Easton C, Hernandez A, Leija M, Pierce D, Bryzski R, Awonuga A, Cedo L, Cline A, Collins K, Krawetz S, Puscheck E, Singh M, Yoscovits M, Barnhart K, Lecks K, Martino L, Marunich R, Snyder P, Schlaff W, Comfort A, Crow M, Hohmann A, Mallette S, Ringbloom M, Tang J, Mason S, DiMaria N, Rhea M, Turner K, Haisenleder D, Trussell J, DelBasso D, Li Y, Makuch R, Patrizio P, Sakai L, Scahill L, Taylor H, Thomas T, Tsang S, Zhang M, Lamar C, DePaolo L, Guzick D, Herring A, Redmond J, Thomas M, Turek P, Wactawski-Wende J, Rebar R, Cato P, Dukic V, Lewis V, Schlegel P, Witter F. Predictors of participant retention in infertility treatment trials. Fertility And Sterility 2015, 104: 1236-1243.e2. PMID: 26354094, PMCID: PMC4630082, DOI: 10.1016/j.fertnstert.2015.08.001.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAdolescentAdultChi-Square DistributionDrug Therapy, CombinationFemaleFertilityFertility Agents, FemaleHumansInfertility, FemaleLogistic ModelsMaleMultivariate AnalysisOdds RatioPatient DropoutsPatient SelectionPolycystic Ovary SyndromePregnancyRandomized Controlled Trials as TopicRisk FactorsTreatment OutcomeYoung AdultConceptsPolycystic ovary syndromeBody mass indexClomiphene citrateClinical trialsHistory of smokingInsurance coverageCombination of metforminMultivariable logistic modelAcademic medical centerRetention of subjectsConduct of RCTsBetter insurance coverageUnexplained infertilityOvary syndromeNormal weightMass indexOriginal RCTTreatment trialsMedical CenterMAIN OUTCOMEWhite raceIntervention studiesRCTsSecondary analysisParticipant retentionImpact of Male and Female Weight, Smoking, and Intercourse Frequency on Live Birth in Women With Polycystic Ovary Syndrome
Polotsky AJ, Allshouse AA, Casson PR, Coutifaris C, Diamond MP, Christman GM, Schlaff WD, Alvero R, Trussell JC, Krawetz SA, Santoro N, Eisenberg E, Zhang H, Legro RS. Impact of Male and Female Weight, Smoking, and Intercourse Frequency on Live Birth in Women With Polycystic Ovary Syndrome. The Journal Of Clinical Endocrinology & Metabolism 2015, 100: 2405-2412. PMID: 25856211, PMCID: PMC4454812, DOI: 10.1210/jc.2015-1178.Peer-Reviewed Original ResearchConceptsPolycystic ovary syndromeBody mass indexFemale body mass indexMale body mass indexLive birthsOvary syndromeFertility treatment successSexual intercourse attemptsLower chanceNormal semen parametersClomiphene citrateIntercourse attemptsII trialObese menObese womenInfertile womenMale obesityMass indexRegular intercourseProspective dataMale factorTreatment successMale smokingLarge cohortIntercourse frequencyAssessment of multiple intrauterine gestations from ovarian stimulation (AMIGOS) trial: baseline characteristics
Diamond MP, Legro RS, Coutifaris C, Alvero R, Robinson RD, Casson P, Christman GM, Ager J, Huang H, Hansen KR, Baker V, Usadi R, Seungdamrong A, Bates GW, Rosen RM, Haisonleder D, Krawetz SA, Barnhart K, Trussell JC, Jin Y, Santoro N, Eisenberg E, Zhang H, Network I. Assessment of multiple intrauterine gestations from ovarian stimulation (AMIGOS) trial: baseline characteristics. Fertility And Sterility 2015, 103: 962-973.e4. PMID: 25707331, PMCID: PMC4529113, DOI: 10.1016/j.fertnstert.2014.12.130.Peer-Reviewed Original ResearchConceptsAntimüllerian hormone levelsAntral follicle countBody mass indexBaseline characteristicsClomiphene citrateOvarian stimulationUnexplained infertilityFollicle countHormone levelsSemen parametersMean body mass indexGood ovarian reserveMultiple Intrauterine GestationsOvarian stimulation (AMIGOS) trialUse of letrozoleComparable patient populationsProspective clinical trialsCause of infertilityOvulation induction medicationsRate of multiplesCommon baseline characteristicsNormal semen parametersBasal FSHInfertility durationBaseline demographics
2014
Letrozole or Clomiphene for Infertility in the Polycystic Ovary Syndrome
Legro RS, Zhang H. Letrozole or Clomiphene for Infertility in the Polycystic Ovary Syndrome. New England Journal Of Medicine 2014, 371: 1462-1464. PMID: 25295506, DOI: 10.1056/nejmc1409550.Peer-Reviewed Original ResearchLetrozole versus Clomiphene for Infertility in the Polycystic Ovary Syndrome
Legro RS, Brzyski RG, Diamond MP, Coutifaris C, Schlaff WD, Casson P, Christman GM, Huang H, Yan Q, Alvero R, Haisenleder DJ, Barnhart KT, Bates GW, Usadi R, Lucidi S, Baker V, Trussell JC, Krawetz SA, Snyder P, Ohl D, Santoro N, Eisenberg E, Zhang H. Letrozole versus Clomiphene for Infertility in the Polycystic Ovary Syndrome. New England Journal Of Medicine 2014, 371: 119-129. PMID: 25006718, PMCID: PMC4175743, DOI: 10.1056/nejmoa1313517.Peer-Reviewed Original ResearchConceptsPolycystic ovary syndromeOvary syndromeCongenital anomaliesLive birthsHigh incidenceOvulation rateSignificant between-group differencesCumulative ovulation rateNormal uterine cavityOverall congenital anomaliesBetter pregnancy outcomesPatent fallopian tubesCumulative live birthMajor congenital anomaliesBetween-group differencesYears of ageClomiphene groupLetrozole groupRotterdam criteriaAdverse eventsHot flushesPregnancy outcomesInfertile womenMulticenter trialPrimary outcome
2013
The Pregnancy in Polycystic Ovary Syndrome II study: baseline characteristics and effects of obesity from a multicenter randomized clinical trial
Legro RS, Brzyski RG, Diamond MP, Coutifaris C, Schlaff WD, Alvero R, Casson P, Christman GM, Huang H, Yan Q, Haisenleder DJ, Barnhart KT, Bates GW, Usadi R, Lucidi R, Baker V, Trussell JC, Krawetz SA, Snyder P, Ohl D, Santoro N, Eisenberg E, Zhang H, Network I. The Pregnancy in Polycystic Ovary Syndrome II study: baseline characteristics and effects of obesity from a multicenter randomized clinical trial. Fertility And Sterility 2013, 101: 258-269.e8. PMID: 24156957, PMCID: PMC3899700, DOI: 10.1016/j.fertnstert.2013.08.056.Peer-Reviewed Original ResearchMeSH KeywordsAdultDouble-Blind MethodFemaleFertility Agents, FemaleHumansMaleObesityPolycystic Ovary SyndromePregnancyYoung AdultConceptsAntimüllerian hormone levelsAntral follicle countPolycystic ovary syndromeBaseline characteristicsFollicle countClinical trialsHormone levelsCross-sectional baseline dataCardiovascular risk factorsEffect of obesityMost metabolic parametersMean semen parametersFSH ratioFSH levelsII studyOvarian volumeOvary syndromeMetabolic syndromeTreatment regimensRisk factorsHealth centersMetabolic dysfunctionMetabolic parametersMAIN OUTCOMETreatment groups
2012
Altering Hirsutism Through Ovulation Induction in Women With Polycystic Ovary Syndrome
Roth LW, Huang H, Legro RS, Diamond MP, Coutifaris C, Carson SA, Steinkampf MP, Carr BR, McGovern PG, Cataldo NA, Gosman GG, Nestler JE, Myers ER, Zhang H, Schlaff WD. Altering Hirsutism Through Ovulation Induction in Women With Polycystic Ovary Syndrome. Obstetrics And Gynecology 2012, 119: 1151-1156. PMID: 22617579, PMCID: PMC3360417, DOI: 10.1097/aog.0b013e31825618fb.Peer-Reviewed Original ResearchMeSH KeywordsAdultClomipheneDouble-Blind MethodDrug Therapy, CombinationFemaleFertility Agents, FemaleHirsutismHumansMetforminOvulation InductionPolycystic Ovary SyndromeYoung AdultConceptsPolycystic ovary syndromeFerriman-Gallwey scoreClomiphene citrateOvary syndromePolycystic Ovary Syndrome IDouble-blind trialDuration of treatmentAbsence of ovulationHirsutism scoreOvulation inductionHirsute womenHirsutismSecondary analysisMetforminWomenGroup assignmentSignificant decreaseSignificant differencesTreatmentSyndromeInfertilityGreater improvementScoresPregnancyGroupEndometrial Shedding Effect on Conception and Live Birth in Women With Polycystic Ovary Syndrome
Diamond MP, Kruger M, Santoro N, Zhang H, Casson P, Schlaff W, Coutifaris C, Brzyski R, Christman G, Carr BR, McGovern PG, Cataldo NA, Steinkampf MP, Gosman GG, Nestler JE, Carson S, Myers EE, Eisenberg E, Legro RS. Endometrial Shedding Effect on Conception and Live Birth in Women With Polycystic Ovary Syndrome. Obstetrics And Gynecology 2012, 119: 902-908. PMID: 22525900, PMCID: PMC4007263, DOI: 10.1097/aog.0b013e31824da35c.Peer-Reviewed Original ResearchConceptsPolycystic ovary syndromeLive birth rateAnovulatory cyclesEndometrial sheddingClomiphene citrateOvary syndromeLive birthsEunice Kennedy Shriver National InstituteBirth rateCommon clinical practiceOccurrence of ovulationRate of conceptionAnovulatory womenOvarian stimulationOvulation inductionSpontaneous mensesProgestin withdrawalChild healthClinical practiceNetwork trialSecondary analysisOvulation rateMetforminAdverse effectsWomenThe Pregnancy in Polycystic Ovary Syndrome II (PPCOS II) trial: Rationale and design of a double-blind randomized trial of clomiphene citrate and letrozole for the treatment of infertility in women with polycystic ovary syndrome
Legro RS, Kunselman AR, Brzyski RG, Casson PR, Diamond MP, Schlaff WD, Christman GM, Coutifaris C, Taylor HS, Eisenberg E, Santoro N, Zhang H, Network F. The Pregnancy in Polycystic Ovary Syndrome II (PPCOS II) trial: Rationale and design of a double-blind randomized trial of clomiphene citrate and letrozole for the treatment of infertility in women with polycystic ovary syndrome. Contemporary Clinical Trials 2012, 33: 470-481. PMID: 22265923, PMCID: PMC3312939, DOI: 10.1016/j.cct.2011.12.005.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAntineoplastic AgentsChi-Square DistributionClomipheneDouble-Blind MethodFemaleFertility Agents, FemaleHealth Status IndicatorsHirsutismHumansHyperandrogenismInfertility, FemaleLetrozoleMiddle AgedNitrilesOvulation InductionPolycystic Ovary SyndromePregnancyQuality of LifeResearch DesignTriazolesWomen's HealthYoung AdultConceptsPolycystic ovary syndromeClomiphene citrateOvary syndromeInfertile womenTreatment armsDouble-blind clinical trialSelective estrogen receptor modulatorsMajor infertility factorOral clomiphene citrateMultiple pregnancy rateFirst-line treatmentLive birth rateEstrogen receptor modulatorsDifferent treatment armsTreatment of infertilityPoor ovulatory responseEndometrial effectsII trialII studyLine treatmentInfertility factorsProgestin withdrawalAromatase inhibitorsClinical trialsFemale infertility
2011
Estimating rates of multiple gestation pregnancies: Sample size calculation from the assessment of multiple intrauterine gestations from ovarian stimulation (AMIGOS) trial
Diamond MP, Mitwally M, Casper R, Ager J, Legro RS, Brzyski R, Casson P, Eisenberg E, Zhang H, Network F. Estimating rates of multiple gestation pregnancies: Sample size calculation from the assessment of multiple intrauterine gestations from ovarian stimulation (AMIGOS) trial. Contemporary Clinical Trials 2011, 32: 902-908. PMID: 21787883, PMCID: PMC3708642, DOI: 10.1016/j.cct.2011.07.009.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAromatase InhibitorsClomipheneDose-Response Relationship, DrugDouble-Blind MethodFemaleFertility Agents, FemaleGonadotropinsHumansInfant, NewbornInfertilityLetrozoleMaleNitrilesOvulation InductionPregnancyPregnancy OutcomePregnancy, MultipleProspective StudiesTreatment OutcomeTriazolesYoung AdultConceptsMultiple Intrauterine GestationsMultiple gestation pregnanciesOvulation inductionUnexplained infertilityGestation pregnanciesIntrauterine gestationMultiple gestationsComparable pregnancy ratesMono-follicular developmentOvarian stimulation (AMIGOS) trialOvarian hyperstimulation syndromePregnancy success ratePublic health benefitsExpense of careHyperstimulation syndromeClomiphene citrateNeonatal morbidityPreterm laborFertility medicationsPreterm infantsIntrauterine inseminationStimulation trialsAromatase inhibitorsPregnancy rateGestation
2010
Decision trees for identifying predictors of treatment effectiveness in clinical trials and its application to ovulation in a study of women with polycystic ovary syndrome
Zhang H, Legro RS, Zhang J, Zhang L, Chen X, Huang H, Casson PR, Schlaff WD, Diamond MP, Krawetz SA, Coutifaris C, Brzyski RG, Christman GM, Santoro N, Eisenberg E. Decision trees for identifying predictors of treatment effectiveness in clinical trials and its application to ovulation in a study of women with polycystic ovary syndrome. Human Reproduction 2010, 25: 2612-2621. PMID: 20716558, PMCID: PMC2939757, DOI: 10.1093/humrep/deq210.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAndrogensAnovulationBody Mass IndexClomipheneDecision TreesDrug Therapy, CombinationFemaleFertility Agents, FemaleHumansInfertility, FemaleMetforminOrgan SizeOvulation InductionPolycystic Ovary SyndromePregnancyProinsulinRandomized Controlled Trials as TopicSex Hormone-Binding GlobulinTreatment OutcomeWaist-Hip RatioConceptsPolycystic ovary syndromeCombination of CCClomiphene citrateClinical trialsOvarian volumeOvary syndromeOvulation inductionHigher sex hormone-binding globulin levelsSex hormone-binding globulin levelsHormone-binding globulin levelsTreatment effectivenessHigher baseline insulinHip circumference ratioIncidence of ovulationBaseline physical characteristicsBaseline laboratoryOvulatory rateClinical parametersHigher waistBaseline variablesPredictive biomarkersGlobulin levelsCircumference ratioOvulatory responseTreatment outcomes