Low dose recombinant FSH treatment may reduce multiple gestations caused by controlled ovarian hyperstimulation and intrauterine insemination

Autor: François Goffinet, Y. Janssens, Juliette Guibert, Françoise Merlet, Michèle Savale, Charles Fournier, Theocharis C. Papageorgiou, Jean-René Zorn
Rok vydání: 2004
Předmět:
Zdroj: BJOG: An International Journal of Obstetrics & Gynaecology. 111:1277-1282
ISSN: 1470-0328
Popis: Objective To evaluate the rate of multiple pregnancies in intrauterine insemination cycles stimulated with a minimal dose of recombinant follicle stimulating hormone (rec-FSH). Design Retrospective study. Setting University Medical Center. Population A total of 1256 patients underwent 3219 consequent intrauterine insemination cycles with minimal ovarian stimulation. Methods Patients received 50 or 75 IU of rec-FSH from day four to day seven. The dose was adjusted according to oestradiol (E2) levels in order to achieve a maximum of two follicles on the day of hCG administration. Main outcome measures Peak E2 levels, the number of follicles >15 mm and pregnancy rates were calculated. The predictive value of E2 levels for multiple gestations was also estimated. Results Of 3219 cycles, 334 resulted in pregnancies (10%). Of these, 238 (91%) were singletons, 28 (8%) twins and 1 (0.3%) was a triplet. The cumulative overall pregnancy rate was 43%. Patients over 40 years old had a significantly lower pregnancy rate per cycle and overall live birth rate (P < 0.05). Most pregnancies (83%) occurred during the first three cycles. Pregnancy rates per cycle varied from 8% for tubal factor to 14% for anovulation infertility. Conclusions Minimal FSH stimulation in intrauterine insemination cycles may reduce the rates of twins and high order multiple pregnancies without affecting overall pregnancy rates.
Databáze: OpenAIRE
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