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Intrauterine insemination versus timed intercourse with clomiphene citrate in polycystic ovary syndrome: a randomized controlled trial.
MedLine Citation:
PMID:  21306326     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective. To compare the efficacy of intrauterine insemination versus timed intercourse with clomiphene citrate as a first-line treatment for anovulatory infertility associated with polycystic ovary syndrome. Design. A randomized controlled trial following the CONSORT criteria. Setting. A university hospital and a private practice setting. Patients. 188 women (525 cycles) with polycystic ovary syndrome. Interventions. Patients received 3 consecutive cycles of ovulation induction with clomiphene citrate and intrauterine insemination (n = 93, 259 cycles) or 3 consecutive cycles of clomiphene citrate with timed intercourse (n = 95, 266 cycles). Outcome measures. Clinical pregnancy rate per cycle, number of growing and mature follicles, serum estradiol, endometrial thickness at the hCG day, serum progesterone, ovulation, miscarriage and live birth rates. Results. There were no differences between both groups regarding the clinical pregnancy rate per cycle and per woman (8.49% vs. 7.89% and 23.6% vs. 22.1%; p = 0.26, p = 0.33 respectively). Two twin pregnancies occurred in each group. Miscarriage and live birth rates were comparable (18.1% vs. 19% and 19.35% vs. 17.89%; p = 0.31, p = 0.33 respectively). No ectopic, higher order pregnancies or cases of ovarian hyperstimulation syndrome occurred. No differences were found regarding the number of follicles, serum progesterone, ovulation rates, estradiol levels and endometrial thickness at the hCG day (7.7 ± 0.4 vs. 7.5 ± 0.6 mm; p = 0.54). Conclusions. Ovulation induction with clomiphene citrate and timed intercourse is as effective as that with intrauterine insemination for achieving pregnancy in polycystic ovary syndrome and can represent the initial treatment option, being less invasive with reduced cost than intrauterine insemination. Clinical Trial Registry ACTRN12610000619044.
Authors:
Hatem Abu Hashim; Osama Ombar; Ibrahim Abd Elaal
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-3
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  -     ISSN:  1600-0412     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-2-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors AOGS© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.
Affiliation:
Department of Obstetrics & Gynecology Department of Diagnostic Radiology Department of Clinical Pathology, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt.
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