A multi-center prospective, randomized, double-blind trial studying the effect of misoprostol on the outcome of intrauterine insemination
| Autor: | Marc Dhont, Kelly Billiet, Willem Ombelet, Diane De Neubourg, Chris Vervaet, An Vermeire, Petra De Sutter, Luc Delbeke, Jan Gerris |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Randomization medicine.medical_treatment Young Adult Double-Blind Method Pregnancy Prostaglandins Synthetic medicine Humans Prospective Studies Prospective cohort study Misoprostol Insemination Artificial Gynecology Cross-Over Studies Obstetrics business.industry Artificial insemination Obstetrics and Gynecology medicine.disease Crossover study Abdominal Pain Clinical trial Administration Intravaginal Reproductive Medicine Gestation lipids (amino acids peptides and proteins) Female Human medicine Uterine Hemorrhage business medicine.drug |
| Zdroj: | Gynecologic and obstetric investigation |
| ISSN: | 1423-002X 0378-7346 |
| Popis: | Background: Because seminal prostaglandins play a role at natural fertilization, it was hypothesized that vaginal supplementation of prostaglandins at the time of intrauterine insemination (IUI) might enhance chances of conception. We investigated the effect of misoprostol, a prostaglandin analogue, on the success rate of IUI. Methods: A multi-center double-blind randomized controlled trial, using a cross-over design with alternating sequence, was designed. Vaginal tablets of misoprostol or placebo were used in conjunction to intrauterine insemination. In total, 199 women, comprising 466 cycles, were analyzed. Main outcome measures were pregnancy rate and prevalence of vaginal bleeding and uterine cramps. Results: The misoprostol group accounted for 146 cycles with 19 pregnancies, whereas the placebo group cycles totaled 164 cycles with 21 pregnancies (13.0 vs. 12.8%, not significant). There was a statistically significant increase in vaginal bleeding (12.3 vs. 1.8%; OR 7.55; 95% CI 2.31-24.48) and abdominal cramping rates (15.1 vs. 4.3%; OR 3.98; 95% CI 1.68-9.39) after application of misoprostol. Due to these severe adverse events the study was prematurely terminated. Conclusion: Although prostaglandins surely play a role in natural human reproduction, vaginal administration of misoprostol at the time of IUI is associated with a high rate of side effects and does not seem to enhance the outcome. Abstract: Background: Because seminal prostaglandins play a role at natural fertilization, it was hypothesized that vaginal supplementation of prostaglandins at the time of intrauterine insemination (IUI) might enhance chances of conception. We investigated the effect of misoprostol, a prostaglandin analogue, on the success rate of IUI. Methods: A multi-center double-blind randomized controlled trial, using a cross-over design with alternating sequence, was designed. Vaginal tablets of misoprostol or placebo were used in conjunction to intrauterine insemination. In total, 199 women, comprising 466 cycles, were analyzed. Main outcome measures were pregnancy rate and prevalence of vaginal bleeding and uterine cramps. Results: The misoprostol group accounted for 146 cycles with 19 pregnancies, whereas the placebo group cycles totaled 164 cycles with 21 pregnancies (13.0 vs. 12.8%, not significant). There was a statistically significant increase in vaginal bleeding (12.3 vs. 1.8%; OR 7.55; 95% CI 2.31-24.48) and abdominal cramping rates (15.1 vs. 4.3%; OR 3.98; 95% CI 1.68-9.39) after application of misoprostol. Due to these severe adverse events the study was prematurely terminated. Conclusion: Although prostaglandins surely play a role in natural human reproduction, vaginal administration of misoprostol at the time of IUI is associated with a high rate of side effects and does not seem to enhance the outcome. Copyright (C) 2008 S. Karger AG, Basel. |
| Databáze: | OpenAIRE |
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