scholarly journals Relationship between pregnancy rate and number of intrauterine insemination cycles during the study of comparative efficacy of letrozole and clomiphene citrate adjuvants to gonadotropin stimulation in controlled ovarian stimulation cycles combined with intrauterine insemination therapy

2021 ◽  
Vol 11 (1) ◽  
pp. 106
Author(s):  
Pankaj Sharma ◽  
Ashok Verma ◽  
Kritika Katoch
Keyword(s):  
Pregnancy Rate ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Randomized Study ◽  
Good Alternative ◽  
Human Menopausal Gonadotropin ◽  
Male Factor ◽  
Medical College ◽  
Group A ◽  
Group B

Background: Infertility is commonly defined as the failure of conception after at least twelve months of unprotected intercourse. Factors contributing are both male and female in which unexplained etiology accounts for 51%, male factor 28%, endometriosis 17% and ovulatory disorders 4%.Methods: Prospective, randomized study was conducted at DRRPG medical college, Tanda, Kangra, Himachal Pradesh. In our study, patients were randomized into two groups of 30 each. Women in group A received clomiphene citrate 100mg/day and group B received letrozole 2.5 mg/day from day 3-7 of menstrual cycle. All the patients received human menopausal gonadotropin 75 U given every alternate day from day 5 until HCG administration. Ovulation was triggered with recombinant HCG (5000 IUIM) when the dominant follicles reached 18 mm in diameter. A single IUI was performed 36 hours later. A maximum of four cycles were given.Results: In our study, total number of induction cycles given in group A and B were 120 and 114 respectively. Out of these, 112 and 111 IUI cycles were done in group A and B respectively. A pregnancy rate of 1.66% and 7.87% per IUI cycle was observed in group A and B respectively.Thus it is concluded that the pregnancy rates were significantly higher in letrozole group (30%) in comparison to clomiphene citrate group (6.66%).Conclusions: Aromatase inhibitor letrozole appears to constitute a good alternative to clomiphene citrate in patients with unexplained infertility undergoing gonadotropin-stimulated COS cycles combined with IUI therapy.

scholarly journals A study for evaluation of two protocols comprising of clomiphene citrate, human menopausal gonadotropin with or without follicle stimulating hormone for ovulation induction in patients with infertility for intrauterine insemination

2019 ◽  
Vol 8 (6) ◽  
pp. 2487
Author(s):  
Ashok Verma ◽  
Shivani Sharma ◽  
Suresh Verma ◽  
Pankaj Sharma ◽  
Tenzin Tsamo Tenga ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Endometrial Thickness ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Human Menopausal Gonadotropin ◽  
Multiple Gestation ◽  
Group A ◽  
Group B

Background: To compare two protocols comprising of FSH/CC/HMG and CC/HMG for ovulation induction and IUI in women with infertility.Methods: 60 women with unexplained infertility were randomized using sequentially numbered opaque envelope method. Group A received inj FSH 150 units on day 2 of menstrual cycle and clomiphene citrate 100 mg from day 3-7, followed by injection HMG 150 units on day 9 of menstrual cycle. Group B received clomiphene citrate 100 mg from day 3-7, and HMG 150 units on day 7 and 9 of the menstrual cycle.  Ovulation triggered with hCG 5000 units when dominant follicle was 18mm. Single IUI was done 36-42 hours afterwards.Results: Pregnancy occurred in 3 out of 30 women in 116 cycles Group A (with FSH) with a pregnancy rate of 10 percent, and 2.8% per cycle. In group B (without FSH) pregnancy occurred in 3 out of 30 women in 117 cycles with pregnancy rate of 10 percent, and 2.6% per cycle. The number of follicles per cycle was 1.36 and follicle size was 18.57 mm in group A. While in Group B numbers of follicles per cycle were 1.22, with average size of 18.9mm. Mean endometrial thickness was 7.7mm in Group A and 6.37 in Group B (p=.01, significant). Mild OHSS was observed in one woman in Group B. No other side effects were observed in both the groups.Conclusions: The controlled ovarian stimulation regimes used in this study are equally effective, easy to administer, require less intensive monitoring and fewer medications, with little risk of OHSS and multiple gestation.

STUDY FOR EVALUATION OF COMPRISING OF CLOMIPHENE CITRATE, HUMAN MENOPAUSAL GONADOTROPIN WITH OR WITHOUT FOLLICLE STIMULATING HORMONE FOR OVULATION INDUCTION IN PATIENTS WITH INFERTILITY FOR INTRAUTERINE INSEMINATION AT NMCH, JAMUHAR, SASARAM, BIHAR

2021 ◽  
pp. 30-32
Author(s):  
Smriti Sinha ◽  
Rita Sinha ◽  
Debarshi Jana
Keyword(s):  
Menstrual Cycle ◽  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Endometrial Thickness ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Human Menopausal Gonadotropin ◽  
Multiple Gestation ◽  
Group A ◽  
Group B

Background: To compare two protocols comprising of FSH/CC/HMG and CC/HMG for ovulation induction and IUI in women with infertility. Methods: 60 women with unexplained infertility were randomized using sequentially numbered opaque envelope method. Group A received inj FSH 150 units on day 2 of menstrual cycle and clomiphene citrate 100 mg from day 3 - 7, followed by injection HMG 150 units on day 9 of menstrual cycle. Group B received clomiphene citrate 100 mg from day 3-7, and HMG 150 units on day 7 and 9 of the menstrual cycle. Ovulation triggered with hCG 5000 units when dominant follicle was 18mm. Single IUI was done 36-42 hours afterwards. Results: Pregnancy occurred in 3 out of 30 women in 116 cycles Group A (with FSH) with a pregnancy rate of 10 percent, and 2.8% per cycle. In group B (without FSH) pregnancy occurred in 3 out of 30 women in 117 cycles with pregnancy rate of 10 percent, and 2.6% per cycle. The number of follicles per cycle was 1.36 and follicle size was 18.57 mm in group A. While in Group B numbers of follicles per cycle were 1.22, with average size of 18.9mm. Mean endometrial thickness was 7.7mm in Group A and 6.37 in Group B (p=.01, signicant). Mild OHSS was observed in one woman in Group B. No other side effects were observed in both the groups. Conclusions: The controlled ovarian stimulation regimes used in this study are equally effective, easy to administer, require less intensive monitoring and fewer medications, with little risk of OHSS and multiple gestation.

scholarly journals The Study on Different Ovulation Induction Protocols used for Intrauterine Insemination and their Pregnancy Rate in Infertile Couples

2021 ◽  
Vol 10 (11) ◽  
pp. 73-82
Author(s):  
Yaminipriya Devarajlu Dhivya Venkatesan ◽  
Balachandar Vellingiri Ravimanickam Thangarasu ◽  
Sarat Battina
Keyword(s):  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Human Menopausal Gonadotropin ◽  
Fertility Drugs ◽  
Group I ◽  
Significant Difference ◽  
Group B ◽  
Group D

Infertility affects millions of people of reproductive age worldwide and has an impact on their families and communities. Infertility is a disease of male or female reproductive system defined by failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Infertility is treated by different fertility drugs, ovulation induction (OI), intrauterine insemination (IUI) and in-vitro fertilization (IVF). The aim of the study is to find out the significant difference in pregnancy rate with different OI protocols used for IUI. OI is the first line treatment given to infertile women. In OI, medications are given to women for egg development and for release of eggs. OI is monitored by follicular study by ultrasonography. Semen is collected from the male partner and processed with culture media to retrieve high motile sperms, which are injected into the uterus of the female. A prospective randomized study was performed among 1343 IUI cycles. OI is started on Day 2 or Day 3 of the menstrual cycle. OI protocol is grouped according to the fertility drugs used for stimulation. The fertility drugs used for the stimulation are Clomiphene Citrate, Letrozole, Recombinant Gonadotropins, Human menopausal Gonadotropins (HMG), Human chorionic Gonadotropin (HCG). Group A uses Clomiphene citrate and HCG, Group B uses Clome, recombinant Gonadotropins and HCG. Group C uses Clome, Human menopausal Gonadotropin and HCG; Group D uses Letrozole and HCG. Group E uses Letrozole recombinant Gonadotropin and HCG. Group F used Letrozole, Human menopausal Gonadotropin and HCG. Group G used recombinant Gonadotropin and HCG. Group H used Human menopausal Gonadotropin and HCG. Group I uses only HCG. Group J was a natural cycle monitoring without any medication and was used as a control. Pregnancy rates were calculated for different age groups with different protocols. The result shows that Group B had 13% pregnancy, Group C had 9%, Group D had 3%, Group E had 10%, Group G had 11%, Group G had 11%, Group H had 7%, Group I had 4%, and Group J had 8% of pregnancy rate. The statistical analysis shows there is no significant difference with different stimulation protocols used.

scholarly journals Comparative Analysis of Effectiveness of Clomiphene Citrate and Letrozole Combined with Low Dose Human Menopausal Gonadotropin for Controlled Ovarian Stimulation in Intrauterine Insemination Cycles

2021 ◽  
Vol 73 (3) ◽  
pp. 198-203
Author(s):  
Padmalaya Thakur ◽  
Sujata Pradhan
Keyword(s):  
Pregnancy Rate ◽  
Ovarian Stimulation ◽  
Low Dose ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Controlled Ovarian Stimulation ◽  
Human Menopausal Gonadotropin ◽  
Group B

Objective: To compare the efficacy of clomiphene citrate and letrozole in combination with low dose human menopausal gonadotropin for controlled ovarian stimulation in intrauterine insemination (IUI) cycles.Methods: During January-2018 to December-2019 for intending 496 IUI cycles, controlled ovarian stimulation was performed with either clomiphene or letrozole combined with human menopausal gonadotropin (hMG), in two arms:  subjects in one arm (Group A) were with clomiphene and hMG in 222 cycles; those in the second arm (Group B) were with letrozole and hMG in 274 cycles. Pregnancy rate and clinical pregnancy rate of both groups were considered as the primary outcomes.Results: Patient characteristics like female age, indications for IUI, type of IUI, endometrial thickness and total motile fraction (TMF) of spermatozoa of male partners were seen similar in both groups. The letrozole-hMG group (Group B) had significantly higher numbers of cycles with single dominant follicle (P=0.01) and human chorionic gonadotropin (hCG) was more frequently used as the ovulation trigger (P=0.03). Pregnancy rate (18.5% vs. 15.3%, P=0.35) and clinical pregnancy rate (18.5% vs. 15.3%, P=0.35) were similar in groups A and B, respectively.Conclusion: Clomiphene citrate and letrozole combined with low dose human menopausal gonadotropin were equally effective for controlled ovarian stimulation in IUI cycles.

Comparison of letrozole and clomiphene citrate efficacy in terms of ovulation induction and pregnancy rate.

2021 ◽  
Vol 28 (05) ◽  
pp. 749-754
Author(s):  
Nadia Sharif ◽  
Uzma Manzoor ◽  
Saadia Bano ◽  
Uzma Shahzaad
Keyword(s):  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Endometrial Thickness ◽  
Controlled Trial ◽  
Clomiphene Citrate ◽  
Epidemiological Data ◽  
P Value ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: To compare the efficacy of Letrozole and clomiphene citrate in Patients of Anovulation polycystic ovarian syndrome with Infertility. Study Design: Randomized Controlled Trial Setting: Department of Obstetrics and Gynecology Independent Medical College Faisalabad. Period: 30-09-2019 to 29-6-2020. Material & Methods: This study included 100 patients with 50 patients in each group. Group A received 2.5 to 5mg letrozole in each cycle from day 3 to 7. Group B received clomiphene citrate 50 to 100 mg incremental dose depending on ovarian response. Both Drugs were given for consecutive 3 to 6 cycles to see response. Main outcome Measure included optimal follicle size (> 18mm), endometrial thickness, and pregnancy rate. Epidemiological data and efficacy outcome measures were recorded on a Performa. Statistical analysis was done using SPSS version 13. Chi-square test applied and p-value <o.o5 was considered significant. Both group included primary infertility patients. Results: The mean age of patients was 28.03+ 3.02 years. Mean age of group A patients was 29.04+3.44 and 28.47+3.90 group B patients. Mono ovulation in group A patients (88.9%) and 27 in group b patients (60.0%). The mean endometrial thickness was 9.6mm + 1.6 in letrozole group and 6.9mm + 1.2 in clomiphene citrate group A. In group A 18% got pregnant from Letrozole group and 1.1% from the group B. Conclusion: Efficacy was significantly higher in group A Patients received letrozole as compared to patients echo received clomiphene citrate. The effects of Letrozole showed better outcome in terms of Ovulation Induction Endometrial Thickness and Pregnancy rate.

scholarly journals Efficacy and Side Effects of Letrozole Over Clomiphene citrate for Ovulation Induction of the Patients with PCOS: A Randomized Controlled Trial

2021 ◽  
Vol 15 (2) ◽  
pp. 69-73
Author(s):  
Poly Begum ◽  
Dipti Rani Shaha ◽  
Md Kamrul Hassan ◽  
Dilruba Zeba
Keyword(s):  
Side Effects ◽  
Pregnancy Rate ◽  
Endometrial Thickness ◽  
Controlled Trial ◽  
Clomiphene Citrate ◽  
Multiple Pregnancy ◽  
Ovulation Rate ◽  
Medical College ◽  
Drug Of Choice ◽  
Group B

Clomiphene citrate (CC) has been the drug of choice for the treatment of anovulatory subfertility in women with polycystic ovarian syndrome (PCOS) for a long time. Despite high ovulation rate of CC, its pregnancy rate is low. Letrozole, an aromatase inhibitor has been considered as an alternative of CC but its effectiveness is yet controversial. Our aim was to compare the efficacy and side effects of Letrozole over CC. This randomized control clinical trial was conducted in Diabetic Association Medical College and Hospital, Faridpur, Bangladesh from January 2018 to December 2019. A total of 160 women diagnosed as PCOS by Rotterdam criteria seeking treatment of subfertility were included in the study. Participants were randomly divided into two groups. Group A got Letrozole and Group B got CC as treatment. Transvaginal ultrasonogram (TVS) was performed on 12 to 13th day of the cycle to see the details of the follicles and the endometrium. The demographic information of the participants and the side effects of the drugs were recorded. Successful pregnancies were followed up for 12 weeks. Ovulation rate was almost similar among the participants of both of the groups. But monofo licular development and pregnancy rate were significantly higher among the Letrozole group (p = 0.004 and p = 0.008 respectively). Multifo licular development, multiple pregnancy, and abortion rate were significantly higher in the CC group. Patients who took Letrozole had significantly higher endometrial thickness than CC group. Both of the groups reported relatively similar incidence of side effects. Due to the higher pregnancy rate and lower incidence of abortion or multiple pregnancy, Letrozole can be an effective alternative to CC for the treatment of anovulatory subfertility of the PCOS patients. Faridpur Med. Coll. J. 2020;15(2): 69-73

scholarly journals COMPARISON OF EFFECT OF CLOMIPHENE CITRATE WITH ESTRADIOL VALERATE V/S LETROZOLE ON PREGNANCY RATE IN INFERTILE WOMEN WITH PCOS

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Mendiratta Suman ◽  
Joshi Amit Kumar ◽  
Netra Harendra Kumar
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Pregnancy Rate ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Estradiol Valerate ◽  
Ovary Syndrome ◽  
Infertile Women ◽  
Group A ◽  
Group B

Background: Polycystic ovary syndrome is the commonest endocrinopathy in anovulatory infertility in young women. It is estimated that infertility affects 10 to 14% of the Indian population of which approximately 25-30% part occupied by PCOS. Methods: This prospective study enrolled 180 infertile women with PCOS, age 21-35 yrs who have taken 1 cycle of clomiphene citrate 100 mg, endometrial thickness <7 mm inspite of follicles greater than 18 mm. Half of them treated with clomiphene citrate with estradiol valerate and remaining half with letrozole. Results: In Group-A treated with clomiphene citrate with estradiol valerate 13 patients (16.3%) conceived and in Group-B treated with letrozole 26 patients (32.5%) conceived. Conclusion: Pregnancy rate is higher in group which treatment with letrozole in comparison with clomiphene citrate plus estradiol valerate. Keywords: Polycystic ovary syndrome, Infertility, Pregnancy rate

scholarly journals Comparison between endoscope assisted powered and conventional adenoidectomy

2020 ◽  
Vol 7 (1) ◽  
pp. 50
Author(s):  
Dimple Sahni ◽  
Gurleen Kaur ◽  
Sanjeev Bhagat ◽  
Parvinder Singh ◽  
Peeyush Verma ◽  
...  
Keyword(s):  
Random Sampling ◽  
Recovery Time ◽  
Operative Time ◽  
Randomized Study ◽  
Intraoperative Blood Loss ◽  
Systematic Random Sampling ◽  
Medical College ◽  
Significant Difference ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Adenoidectomy is one of the commonest operations done on children. It is conventionally performed using the curettage method. This present study was done to compare the results of endoscopic powered adenoidectomy and conventional adenoidectomy.</p><p class="abstract"><strong>Methods:</strong> The present prospective randomized study was conducted among 50 patients between 4-16 years of age requiring adenoidectomy with or without tonsillectomy in department of ENT in Government Medical College and Rajindra Hospital, Patiala. All the 50 patients were divided into two groups (group A and group B) by systematic random sampling. Group A consisted of 25 patients who underwent conventional curettage adenoidectomy and group B consisted of 25 patients who underwent Microdebrider-Assisted Adenoidectomy.  </p><p class="abstract"><strong>Results:</strong> In group A and B, mean±SD intraoperative blood loss (in ml) was 20.60±7.96 and 30.60±7.96 respectively. Mean±SD operative time (in minutes) was 28.60±4.71 in group A, while in group B it was 39.60±4.71 with statistically significant difference. Complete adenoid removal was found in 52% of the subjects in group A while it was found in 96% of the subjects in group B with statistically significant difference. In group A, mean±SD recovery time (in hrs) observed was 33.52±10.58 while in group B, recovery time (in hours) observed was 36.22±11.31.</p><p class="abstract"><strong>Conclusions:</strong> Based on the results of this study, it can be concluded that the new method of microdebrider assisted powered adenoidectomy was found to be safer and more useful tool for adenoidectomy than conventional method.</p>

scholarly journals Does increasing the number of inseminations per cycle increase the probability of conception? a randomized trial comparing single versus double intrauterine insemination

2020 ◽  
Vol 9 (8) ◽  
pp. 3171
Author(s):  
Yasaswi Khandavalli ◽  
Seema Rai ◽  
Rama Singodiya Lodha
Keyword(s):  
Pregnancy Rate ◽  
Intrauterine Insemination ◽  
Randomized Study ◽  
Male Factor ◽  
Non Invasive ◽  
Significant Difference ◽  
The Difference ◽  
Infertility Patients ◽  
Larger Sample ◽  
Single Versus

Background: Intrauterine insemination (IUI) remains an inexpensive, non-invasive, and effective first-line artificial insemination technique. The technique of IUI has evolved through various innovations since the time Cohen published the first report of IUI in 1962, and the success rate increased from 5% to >20%. The success of IUI depends upon several factors; two such prognostic factors are the timing and frequency of insemination.  The objective of this study was to compare the effectiveness of single versus double intrauterine insemination.Methods: This prospective randomized study was carried out in 130 patients with male factor infertility, PCOS and unexplained infertility. Patients were randomly assigned into two groups. In the first group of 65 patients, single IUI was applied at 36 to 40 hours after HCG administration, to the other 65 patients in the second group, double IUIs were applied at 12 to 16 hours and 36 to 40 hours after HCG administration. The primary end-point of the study was to compare the clinical pregnancy rate between the two groups.Results: The overall pregnancy rate was 18.46% (12/65) for single IUI group and 30.76% (20/65) for double IUI group. There was a no statistically significant difference between single and double IUI groups (p=0.16).Conclusions: This study did find a higher pregnancy rate following double IUI; however, the difference was not statistically significant. Further, larger sample size studies are required to determine if double IUI increases the pregnancy rate.

scholarly journals Conception rate with or without hCG trigger in clomiphene induced cycles

2021 ◽  
Vol 10 (8) ◽  
pp. 3142
Author(s):  
Aruna Verma ◽  
Abhilasha Gupta ◽  
Monika Kashyap ◽  
Juveriya Meraj
Keyword(s):  
Clomiphene Citrate ◽  
Conception Rate ◽  
Lh Surge ◽  
Medical College ◽  
Follicle Rupture ◽  
Group A ◽  
Follicle Size ◽  
Group B ◽  
Hcg Trigger

Background: Clomiphene citrate (CC) is still the most common drug for ovulation induction. Most physicians use hCG trigger routinely for follicle rupture. Ideally hCG is recommended only where there is no spontaneous LH surge. Hence this study was conducted to see the role of hCG for follicle rupture in CC induced cycle. Aims and objectives of the study were to compare the ovulation rate in CC induced cycle with or without hCG trigger and finally the conception rate.Methods: Study was conducted in the department of OBG, LLRM medical college Meerut on women with anovulatory infertility. All women were given 50-100 mg CC. Follicular study from D-9 was done till follicle rupture. Women in group A were observed without any trigger and women in group B were given inj. hCG trigger 10,000 IU when follicle size reached 20-22 mm.Results: Conception rates were 25% Vs 31% in group A and group B. Follicle rupture was seen in 84% cases in group A and 71% in group B. Results were comparable in both the groups.Conclusions: By adding inj. hCG for ovulation trigger does not increase the conception rate. LH surge is already there in CC induced cycles. It is having role only in cases where no LH surge is there. 

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