Document Detail


Sequential clomiphene citrate and human menopausal gonadotrophin for ovulation induction: comparison to clomiphene citrate alone and human menopausal gonadotrophin alone.
MedLine Citation:
PMID:  8458927     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The need for frequent injections and monitoring, the possibility of multiple gestations, and the higher cost compared to clomiphene citrate, prevents many clinicians from using human menopausal gonadotrophin (HMG) for ovulation induction. A sequential medication regimen, in which HMG is taken after clomiphene, overcomes these problems. We retrospectively compared per cycle fecundity and birth rates in 119 cycles of clomiphene-HMG, 524 cycles of clomiphene alone, 57 cycles of HMG alone, and 79 cycles of concurrent HMG and clomiphene in patients receiving intra-uterine insemination (IUI), who were free of endometriosis or tubal disease. Per cycle fecundity for clomiphene-HMG was 22% [95% confidence interval (CI) 12-34%], double that of clomiphene alone (11%) (95% CI 8-14%) (P < 0.01), and equal to HMG alone (18%) (95% CI 7-29%) or HMG and clomiphene together (19%) (95% CI 10-28%). The multiple birth rate for clomiphene-HMG (7/21) equalled that for HMG alone (3/12) and HMG and clomiphene together (3/8). The average number of ampoules of HMG required [follicle stimulating hormone (FSH) 75 mIU, luteinizing hormone (LH) 75 mIU] was decreased by 65% from 24.5 +/- 1.0 for HMG or HMG and clomiphene together to 8.6 +/- 0.3 for clomiphene-HMG (P < 0.001). Per cycle fecundity was identical when one, two or three ampoules of HMG per day were administered after clomiphene. We conclude that ovulation induction with sequential clomiphene-HMG results in fecundity double that of clomiphene alone and equal to HMG alone or concurrent with clomiphene, thereby reducing the requirement for HMG.
Authors:
R P Dickey; T T Olar; S N Taylor; D N Curole; P H Rye
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  8     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  1993 Jan 
Date Detail:
Created Date:  1993-04-23     Completed Date:  1993-04-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  56-9     Citation Subset:  IM    
Affiliation:
Fertility Institute of New Orleans, LA 70128.
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MeSH Terms
Descriptor/Qualifier:
Clomiphene / administration & dosage*
Drug Therapy, Combination
Female
Fertility / drug effects*
Humans
Menotropins / administration & dosage*
Ovulation Induction / methods*
Pregnancy
Pregnancy, Multiple
Retrospective Studies
Chemical
Reg. No./Substance:
61489-71-2/Menotropins; 911-45-5/Clomiphene

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


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