Preventing high-order multiple pregnancies during controlled ovarian hyperstimulation and intrauterine insemination: 3 years’ experience using low-dose recombinant follicle-stimulating hormone and gonadotropin-releasing hormone antagonists
| Autor: | Anna Elisa Nicolosi, Guido Ragni, Mariangela Arnoldi, Pier Giorgio Crosignani, Ilaria Caliari, Edgardo Somigliana |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
medicine.medical_specialty Pregnancy Rate medicine.medical_treatment Gonadotropin-releasing hormone Controlled ovarian hyperstimulation Biology Gonadotropin-Releasing Hormone Follicle-stimulating hormone Follicle Ovarian Follicle Ovulation Induction Pregnancy medicine Humans Insemination Artificial Retrospective Studies Ultrasonography Gynecology Dose-Response Relationship Drug Obstetrics Artificial insemination Obstetrics and Gynecology Recombinant Proteins Pregnancy rate Treatment Outcome Reproductive Medicine In utero Female Preventive Medicine Follicle Stimulating Hormone Pregnancy Multiple Hormone |
| Zdroj: | Fertility and Sterility. 85:619-624 |
| ISSN: | 0015-0282 |
| Popis: | Objective To employ protocols of mild ovarian stimulation to prevent an excessively elevated rate of high-order multiple pregnancies. Design Case series. Setting University hospital. Patient(s) Six hundred and twenty one consecutive patients undergoing 1,259 controlled ovarian hyperstimulation and intrauterine insemination cycles. Intervention(s) Patients received 50 IU per day of recombinant follicle-stimulating hormone (FSH) starting the third day of the cycle, then a gonadotropin-releasing hormone (GnRH) antagonist on the day in which a follicle ≥13 mm was visualized. Cycles were canceled if three or more follicles ≥16 mm and/or five or more follicles ≥11 mm were detected. Main Outcome Measure(s) Rate of high-order multiple pregnancies. Result(s) The clinical pregnancy rate per initiated cycle was 9.2% (95% confidence interval, 7.5–11.1%). The incidence of twins and high-order multiple pregnancies was 9.5% (95% CI, 5.3–16.2%) and 0 (0.0–3.2%), respectively. Conclusion(s) In controlled ovarian hyperstimulation and intrauterine insemination cycles, a protocol of 50 IU of recombinant FSH daily combined with the use of GnRH antagonists and a policy of strict cancellation based on echographic criteria are associated with a satisfactory pregnancy rate per initiated cycle and a low risk of high-order multiple pregnancies. |
| Databáze: | OpenAIRE |
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