Exogenous gonadotropin therapy and intrauterine insemination: The role of etiology and prognostic factors
Middle East Fertility Society Journal, cilt.3, sa.2, ss.145-153, 1998 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 3 Sayı: 2
- Basım Tarihi: 1998
- Dergi Adı: Middle East Fertility Society Journal
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.145-153
- Anahtar Kelimeler: COH, Gonadotropins, IUI, Male subfertility, Ovulatory disorders, Unexplained infertility
- Trakya Üniversitesi Adresli: Evet
Özet
Objectives: To investigate the results of exogenous gonadotropin therapy (hMG) and intrauterine insemination (IUI) in various forms of infertility and to identify some prognostic factors for the success of this therapy. Design: Retrospective analysis. Setting: A university hospital. Subjects: Eighty nine women undergoing a total of 158 cycles were treated by a combined therapy regimen consisting of (hMG) or urinary FSH, and (hCG), and IUI. Infertile couples were divided into three distinct groups with respect to the etiologic factor: group I, male subfertility (n patient = 9, n cycle = 12); group II, unexplained infertility (23/39); and group III, ovulatory disorders (57/107). Women with ovulatory disorders were also divided as group IIIA (15/42), which included patients with World Health Organization (WHO) group I ovulatory dysfunction and group IIIB (42/65), which included patients with WHO group II ovulatory dysfunction. Main Outcome Measure(s): Total number of ampules of gonadotropins used in the cycle, duration of ovulation induction, serum estradiol (E2) level and number of mature follicles (diameter > 14 mm) on the day of hCG administration and also ovulation, pregnancy and complication rates of cycles in each group were analyzed. Results: Mean duration of ovulation induction and mean number of ampules per cycle were significantly higher in group III than those in other groups (p ≤ 0.0001). Patients in group III had more mature follicles prior to hCG administration than those in group II (p < 0.001). Mean number of ampules per cycle in group IIIA was also higher than those in group IIIB (p < 0.0001). Ovulation rates per cycle were 83% in group I, 90% in group II, 81% in group IIIA, and 74% in group IIIB. Pregnancy rates per cycle were 0%, 13%, 7%, and 22% in each group, respectively. There were no pregnancies in cycles in which more than 30 ampules of gonadotropins were used and in women whose ages were above 40 or below 20 years. The highest pregnancy rates were found when serum E2 levels were between 500 and 2,000 pg/mL and number of mature follicles was 6 or 7 on the day of hCG administration. Conclusion: Exogenous gonadotropin therapy and IUI might be administered in unexplained infertility and infertility due to ovulatory disorders before going on with assisted reproductive technologies. However, ovulation induction with gonadotropins may not enhance the pregnancy rate in infertile couples with male subfertility.