Probability of Pregnancy With Mono vs Multiple Folliculogenesis in Women With Unexplained Infertility.

Autor:	Plowden TC; Department of Gynecologic Surgery and Obstetrics, Womack Army Medical Center, Fort Bragg, NC 28310, USA., Mumford SL; Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD 20892, USA., Wild RA; Department of Obstetrics and Gynecology, OUHSC, Oklahoma City, OK 73117, USA., Cedars MI; Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA 94158, CA, USA., Steiner AZ; Duke University Medical Center, Durham, NC 27710, USA., Franasiak JM; RMA New Jersey, Thomas Jefferson University, Basking Ridge, NJ 07920, USA., Diamond MP; Augusta University Medical Center, Augusta, GA 30912, USA., Santoro N; Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO 80045, USA.
Jazyk:	angličtina
Zdroj:	Journal of the Endocrine Society [J Endocr Soc] 2022 Sep 15; Vol. 7 (1), pp. bvac142. Date of Electronic Publication: 2022 Sep 15 (Print Publication: 2022).
DOI:	10.1210/jendso/bvac142
Abstrakt:	Context: Ovarian stimulation (OS) increases pregnancy rates but can cause multiple folliculogenesis and multiple pregnancy. Objective: To determine whether the probability of pregnancy differs in OS cycles with mono- vs multifolliculogenesis in women with unexplained infertility (UI). Design: Secondary analysis of a multicenter, randomized controlled trial: Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation with 3 treatment arms: gonadotropins, clomiphene, or letrozole, combined with intrauterine insemination. Women were categorized as having either 1 or ≥ 2 mature follicles (≥ 16 mm). Relative risk (RR) and 95% CIs for clinical pregnancy and live birth by number of follicles were estimated using generalized linear models adjusted for age, body mass index, years of infertility, and history of prior live birth. Setting: 12 US-based clinical sites. Participants: Normally cycling women aged 18 to 40 years with a normal uterine cavity and at least 1 patent fallopian tube. Male partners with ≥ 5 million total motile sperm. Interventions: Gonadotropins, clomiphene, or letrozole with insemination. Main Outcome Measures: Clinical pregnancy rates (CPR) and live birth rates (LBR). Results: A single mature follicle > 16 mm resulted in lower CPR (RR, 0.70; 95% CI, 0.54-0.90) and LBR (RR, 0.67; 95% CI, 0.51-0.89) compared with ≥ 2 mature follicles. When stratified by treatment modality, no association of follicle number with CPR or LBR was observed for letrozole or clomiphene, but women using gonadotropins had lower CPR and LBR with monofolliculogenesis. Conclusion: In couples undergoing gonadotropin treatment for UI, monofolliculogenesis following OS is related to a lower rate of live birth. (Published by Oxford University Press on behalf of the Endocrine Society 2022.)
Databáze:	MEDLINE
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