Document Detail


Effect of diagnosis, age, sperm quality, and number of preovulatory follicles on the outcome of multiple cycles of clomiphene citrate-intrauterine insemination.
MedLine Citation:
PMID:  12413999     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine how diagnosis, age, sperm quality, and number of preovulatory follicles affect pregnancy rates when multiple cycles of clomiphene citrate (CC)-IUI are performed. DESIGN: Fifteen-year prospective observational study. SETTING: Private infertility clinic. PATIENT(S): Three thousand, three hundred eighty-one cycles of husband or donor IUI. INTERVENTION(S): Ovulation induction with CC and IUI. MAIN OUTCOME MEASURE(S): Per-cycle pregnancy rate (PR), cumulative pregnancy rate (CPR). RESULT(S): Pregnancy rates remained constant through four cycles, then fell significantly for diagnoses other than ovulatory dysfunction. Mean PRs for cycles 1-4 were significantly lower for patients with the following characteristics: age >/=43 years, poor semen quality, single preovulatory follicles, and diagnoses other than ovulatory dysfunction. Additional cycles of CC-IUI compensated for low PRs because of age, semen quality, or number of follicles. After four cycles, CPRs were 46% for ovulatory dysfunction; 38% for cervical factor, male factor, and unexplained infertility; 34% for endometriosis; and 26% for tubal factor. After six cycles, CPRs were 65% for ovulation dysfunction, 35% for endometriosis, and unchanged for other diagnoses. CONCLUSION(S): Clomiphene citrate-intrauterine insemination should be performed for a minimum of four cycles. Additional cycles of CC-IUI can compensate for low pregnancy rates due to age, semen quality, or follicle number in patients with ovulation dysfunction.
Authors:
Richard P Dickey; Steven N Taylor; Peter Y Lu; Belinda M Sartor; Phillip H Rye; Roman Pyrzak
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Fertility and sterility     Volume:  78     ISSN:  0015-0282     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-11-04     Completed Date:  2002-12-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1088-95     Citation Subset:  IM    
Affiliation:
The Fertility Institute of New Orleans, New Orleans, Louisiana 70128, USA. info@fertilityinstitute.com
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MeSH Terms
Descriptor/Qualifier:
Aging / physiology
Clomiphene / therapeutic use*
Female
Follicular Phase
Humans
Infertility, Female / etiology,  therapy*
Infertility, Male / etiology,  therapy*
Insemination, Artificial, Heterologous*
Insemination, Artificial, Homologous*
Male
Ovarian Follicle / physiopathology
Pregnancy
Pregnancy Rate
Prospective Studies
Spermatozoa / physiology
Treatment Outcome
Chemical
Reg. No./Substance:
911-45-5/Clomiphene
Comments/Corrections
Comment In:
Fertil Steril. 2003 Jun;79(6):1467-8; author reply 1468   [PMID:  12798908 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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