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The impact of ovarian stimulation on the outcome of intrauterine insemination treatment: an analysis of 8893 cycles
Author(s) -
Liu Jinyong,
Li TinChiu,
Wang Jing,
Wang Wei,
Hou Zhen,
Liu Jiayin
Publication year - 2016
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.14020
Subject(s) - stimulation , letrozole , ovarian hyperstimulation syndrome , live birth , menotropins , ovulation induction , pregnancy rate , insemination , medicine , gynecology , hmg coa reductase , andrology , ovulation , pregnancy , biology , endocrinology , in vitro fertilisation , hormone , aromatase , biochemistry , cancer , breast cancer , reductase , sperm , genetics , enzyme
Objective To evaluate the impact of ovarian stimulation on the outcome of intrauterine insemination ( IUI ). Design Retrospective analysis. Setting A single university‐based centre. Population A total of 5109 couples with 8893 cycles. Methods The outcome of IUI with different protocols for ovarian stimulation was examined. Main outcome measures The live birth rate ( LBR ), twin pregnancy rate and ovarian hyperstimulation syndrome ( OHSS ). Results In ovulatory women without ovarian stimulation, the LBR was 7.6%. Stimulation with clomifene citrate ( CC ), letrozole ( LE ), human menopausal gonadotrophin ( HMG ), CC or LE combined with HMG achieved LBR s of 6.1, 5, 7.9, 8 and 12.2%, respectively. LE combined with HMG achieved a significantly improved LBR compared with no stimulation. HMG stimulation was associated with a higher rate of twins (7.4%) than no stimulation (0%, P < 0.01). In ovulatory women, the LBR appeared lower in CC and LE compared with no stimulation ( P > 0.05). In anovulatory women, ovarian stimulation with CC , LE , HMG , CC or LE combined with HMG achieved LBR s of 11.3, 5.1, 11.8, 12.6 and 13.6%, respectively. No significant difference was observed. There were no triplet pregnancies or OHSS in stimulated cycles. Conclusions In ovulatory women, ovarian stimulation with LE combined with HMG achieved a significantly improved live birth rate. HMG stimulation resulted in a high risk for twins. Tweetable abstract In ovulatory women, ovarian stimulation with letrozole and HMG resulted in a significantly improved LBR .