Original research article A pilot study on the use of a 7-day course of letrozole followed by misoprostol for the termination of early pregnancy up to 63 days

AbstractBackground: Our previous randomized controlled study showed that the complete abortion rate in termination of pregnancy up to 63days with the combined use of letrozole for 3 days followed by vaginal misoprostol was significantly higher than that of misoprostolalone. A positive correlation was observed between the basal estradiol level and the failure rate. We performed this pilot study to assess ifa longer course of letrozole followed by misoprostol would improve the estradiol suppression and the complete abortion rate of pregnancyup to 63 days.Study Design: Twenty subjects requesting legal termination of pregnancies up to 63 days were recruited. Medical abortion was offered withletrozole 10 mg daily for 7 days followed by vaginal misoprostol 800 mcg on the 7th day.Results: Median induction-to-abortion interval was 7.5 h (range, 4.75–10.75 h). Overall complete abortion rate was 95%. All subjects withgestation ≤49 days (12/12) as well as 87.5% of subjects with gestation between 50 and 63 days (7/8) had complete abortion. No majoradverse event were reported and over 88% of women would like to have medical termination as an option should it be required in the future.Conclusion: This pilot study showed that a 7-day course of letrozole followed by vaginal misoprostol was associated with a very highcomplete abortion rate (95%) which is comparable to the standard regimen with sequential use of mifepristone and misoprostol in medicaltermination of early pregnancy up to 63 days.© 2012 Elsevier Inc. All rights reserved.