Low dose hMG as a first choice for Ovarian stimulation in IUI cycles
Abstract
Objective: to compare pregnancy rates following low dose human menopausal gonadotrophin as a first choice
in couples undergoing intrauterine insemination
Study Design: prospective controlled trial.
Patients & Methods: This study conducted at the Kasr El-Aini Hospital in which the subfertile couples with
unexplained infertility or mild male factor undergoing IUI were allocated either to Group (1): clomiphene
citrate or Group (2): hMG one ampoule daily. Each couple had three cycles of IUI unless pregnancy occurs.
Results: There were 8 pregnancies in the 23 patients and 66 cycles in the clomide group and there were 14
pregnancies in the 22 patients and 59 cycles in the hMG group. There was no statistical significance in the
pregnancy rates between the two groups Odds Ratio = 0.443 95% CI 0.171 - 1.149. P value = 0.071.
Conclusion: Induction of ovulation using low dose hMG is an attractive alternative to using clomiphene citrate
in the stimulated IUI cycles.
References
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Mahani, I. M., & Afnan, M. (2004). The pregnancy rates with intrauterine insemination (IUI) in superovulated cycles employing different protocols (clomiphene citrate (CC), human menopausal gonadotropin (HMG) and HMG + CC) and in natural ovulatory cycle. J Pak Med Assoc, 54, 503-505. [Google Scholar]
Demirol, A., & Gurgan, T. (2006). Comparison of different gonadotrophin preparations in intrauterine insemination cycles for the treatment of unexplained infertility: a prospective, randomized study. Human Reproduction, 22(1), 97-100. Retrieved from http://www.humrep.oxfordjournals.org/cgi/doi/10.1093/humrep/del335 doi:10.1093/humrep/del335 [Google Scholar]
Dhaliwal, L. K., Sialy, R. K., Gopalan, S., & Majumdar, S. (2000). Minimal stimulation protocol for use with intrauterine insemination in the treatment of infertility. Int J Fertil Womens Med, 45, 232-235. [Google Scholar]
Goverde, A. J., Mc Donnell J,, , Vermeiden, J. P. W., Schats, R., Rutten, F. F. H., & Schoemaker, J. (2000). Intrauterine insemination or in-vitro fertilisation in idiopatic subfertility and male subfertility: a randomised trial and cost-effectiveness analysis. Lancet. , 355, 13-18. [Google Scholar]
Al-Inany, H. G., Abou-Setta, A. M., Aboulghar, M. A., Mansour, R. T., & Serour, G. I. (2008). Efficacy and safety of human menopausal gonadotrophins versus recombinant FSH: a meta-analysis. Reprod Biomed Online. , 16, 81-88. [Google Scholar]
Guzick, D. S., Sullivan, M. W., Adamson, G. D., Cedars, M. I., & Falk, R. J. (1998). Efficacy of treatment for unexplained infertility. Fertil Steril. , 70, 207-213. [Google Scholar]
Ibérico, G., Vioque, J., Ariza, N., Lozano, J. M., Roca, M., Llácer, J., & Bernabeu, R. (2004). Analysis of factors influencing pregnancy rates in homologous intrauterine insemination. Fertility and Sterility, 81(5), 1308-1313. Retrieved from http://linkinghub.elsevier.com/retrieve/pii/S0015028204000366 doi:10.1016/j.fertnstert.2003.09.062 [Google Scholar]
Karlström, P. O., Bergh, T., & Lundkvist, O. (1993). A prospective randomized trial of artificial insemination versus intercourse in cycles stimulated with human menopausal gonadotrophin or clomiphene citrate. Fertil Steril. , 59, 3554-3559. [Google Scholar]
,, , & Ecochard R, Mathieu C, Royere D, Blache G, Rabilloud M, Czyba JC, (2000). A randomized prospective study comparing pregnancy rates after clomiphene citrate and human menopausal gonadotropin before intrauterine insemination. Fertil Steril, 73(1), 90-3. pmid:10632419 [Google Scholar]
Matorras, R., Diaz, T., Corcostegui, B., Ramón, O., & Pijoan, J. I. (2002). Ovarian stimulation in intrauterine insemination with donor sperm: a randomized study comparing clomiphene citrate in fixed protocol versus highly purified urinary FSH. Hum Reprod. , 17, 2107-2111. [Google Scholar]
Hannoun, A., Abu-Musa, A., Kaspar, H., & Khalil, A. (1998). Intrauterine insemination IUI: the effect of ovarian stimulation and infertility diagnosis on pregnancy outcome. Clin Exp Obstet Gynecol. , 25, 4144-4146. [Google Scholar]
Athaullah, N., Proctor, M., & Johnson, N. P. (2002). Oral versus injectable ovulation induction agents for unexplained subfertility. Cochrane Database Syst Rev, 3, [Google Scholar]
Cantineau, A. E. P., Cohlen, B. J., & Heineman, M. J. (2007). Ovarian stimulation protocols (anti-oestrogens, gonadotrophins with and without GnRH agonists/antagonists) for intrauterine insemination (IUI) in women with subfertility. Cochrane Database Syst Rev.(2): CD005356. Review, [Google Scholar]
--
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