Minimal Stimulation Using Gonadotropin Combined with Clomiphene Citrate or Letrozole for Intrauterine Insemination.
10.3349/ymj.2015.56.2.490
- Author:
Bo Hyon YUN
1
;
Seung Joo CHON
;
Joo Hyun PARK
;
Seok Kyo SEO
;
SiHyun CHO
;
Young Sik CHOI
;
Seok Hyun KIM
;
Byung Seok LEE
Author Information
1. Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. yschoi08@yuhs.ac
- Publication Type:Original Article ; Evaluation Studies ; Research Support, Non-U.S. Gov't
- Keywords:
Intrauterine insemination;
minimal stimulation;
gonadotropin;
letrozole;
clomiphene citrate
- MeSH:
Adult;
Aromatase Inhibitors/administration & dosage;
Clomiphene/*administration & dosage/therapeutic use;
Drug Administration Schedule;
Drug Combinations;
Female;
Fertility Agents, Female/administration & dosage/therapeutic use;
Fertilization in Vitro;
Gonadotropins/*administration & dosage;
Humans;
Infertility, Female/*drug therapy;
Insemination, Artificial/*statistics & numerical data;
Nitriles/*administration & dosage;
Ovulation Induction/methods/*statistics & numerical data;
Pregnancy;
Pregnancy Rate;
Treatment Outcome;
Triazoles/*administration & dosage
- From:Yonsei Medical Journal
2015;56(2):490-496
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To evaluate the efficacy of minimal stimulation using discretely administered gonadotropin combined with clomiphene citrate (CC) or letrozole (LTZ) for intrauterine insemination (IUI) cycles. MATERIALS AND METHODS: Total 257 IUI cycles from 158 infertile couples were assessed. A CC dose of 100 mg/day (n=126 cycles) or a LTZ dose of 5 mg/day (n=131 cycles) was administered on days 3-5 of the menstrual cycle for 5 days. Each group received human menopausal gonadotropin at a dose of 150 IU by two or three alternative day: CC combined with alternate-day regimen for 2 or 3 days (CC+300, n=37; CC+450, n=89) and LTZ combined with alternate-day regimen for 2 or 3 days (LTZ+300, n=36; LTZ+450, n=95). RESULTS: The clinical pregnancy rate was comparable between the CC and LTZ groups (18.3% vs. 13.0%, p=0.243). The clinical pregnancy rate also showed no significant difference among the 4 groups (21.6% vs. 16.9% vs. 11.1% vs. 12.6%, p=0.507). The multiple pregnancy rate was significantly higher in LTZ compared to CC group (37.5% vs. 8.7%, p=0.028) and in the LTZ+450 compared to CC+450 group (50% vs. 13.3%, p=0.038). Overall, there were 15 cases of ovarian hyperstimulation syndrome (OHSS), with the prevalence being significantly lower in the LTZ compared to CC group (1.5% vs. 10.3%, p=0.003). OHSS was more prevalent in the CC+450 compared to the LTZ+450 group (12.4% vs. 1.1%, p=0.002). CONCLUSION: Our findings suggest that minimal stimulation using two alternate-day gonadotropin with LTZ decreases the development of OHSS and multiple pregnancies, while maintaining comparable pregnancy rates in IUI cycles.
