scholarly journals Perbandingan hasil stimulasi ovarium dengan kombinasi klomifen sitrat gonadotropin dan klomifen sitrat pada inseminasi intra uteri

2016 ◽  
Vol 3 (2) ◽  
pp. 90
Author(s):  
Farida Indriani ◽  
Shofwal Widad ◽  
Sulchan Sofoewan
Keyword(s):  
Ovarian Stimulation ◽  
Endometrial Thickness ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Combination Group ◽  
Infertile Couple ◽  
Male Factor ◽  
Combination Drug ◽  
Easy Method ◽  
Mature Follicle

Background: Infertile couple with the cause of unexplained infertility and male factor can follow intrauterine insemination (IUI) program as a cheap and easy method for infertility therapy. Ovarian stimulation by combination of clomiphene citrate and gonadotropin and also clomiphene citrate alone was done as a superovulation mode to get higher number of mature follicle to gain higher pregnancy rate. Objective : To compare the amount of mature follicles and  endometrial thickness as an outcome of ovarian stimulation between combination drug of clomiphene citrate and gonadotrophin with clomiphene citrate alone.Methods: Observational retrospective cohort. Subject is one cycle intrauterine insemination stimulated either by combination CC gonadotrophin or CC alone, eligible in inclusion criteria and exclusion criteria. Statistic test used was independent t-test, chi-square and logistic regression.Location of study: Infertility Clinic of  Permata Hati, dr. Sardjito Hospital, Yogyakarta.Result: A total of 142 cycle from 98 couples followed IUI and stimulated by combination CC gonadotrophin (n=72) or CC alone (n=70). Multiple mature follicle number was different and statistically significant 77% vs 54%, RR 1,433 (IK95% 1,118-1,836), p=0,005, while endometrial thickness > 7mm was more frequent in combination group but not statistically different with percentage 81,9% vs 74,3%, RR 1,103 (CI95% 0,926-1,315), p=0,367.Conclusion: Ovarian stimulation by combination CC gonadotropin resulting of more multiple mature follicle number while  good endometrial thickness was more in combination group but not statistically significant.Keywords: ovarian stimulation, clomiphene citrate, gonadotrophin, multifollicular, endometrial thickness

scholarly journals Comparison of pregnancy outcome between clomiphene citrate and sequential clomiphene citrate+human menopausal gonadotropin in intrauterine insemination

2020 ◽  
Vol 9 (8) ◽  
pp. 3302
Author(s):  
Ankita Singh ◽  
Rohan Palshetkar ◽  
Namrata Singh ◽  
Awyay Rege
Keyword(s):  
Live Birth ◽  
Ovarian Stimulation ◽  
Endometrial Thickness ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Human Menopausal Gonadotropin ◽  
Birth Rates ◽  
Cross Sectional ◽  
Live Birth Rates ◽  
Significant Difference

Background: Intrauterine insemination (IUI) has been widely used as a common treatment for infertile couples. This study compares the sequential clomiphene citrate (CC) treatment with CC and human menopausal gonadotropin (hMG) treatment in women undergoing IUI. Therefore, this study was designed to determine the effects of addition of gonadotropin (CC+hMG) would improve the pregnancy rate in women undergoing IUI. And also compare the sequential CC+hMG treatment with CC treatment in women undergoing IUI.Methods: A cross-sectional study design was conducted at D. Y. Patil Fertility Centre, D.Y Patil Hospital, Navi Mumbai from September 2018 to August 2019. Source populations were all patients who live in Mumbai, Maharashtra, India. A total of 67 patients were enrolled in this study. (It consisted of 67 sub fertile couples undergoing ovarian stimulation for IUI cycles). Results: There was no significant difference between the two studied groups regarding endometrial thickness (8.3±2.1 versus 9.7±2.8, respectively), number of mature follicles on the day of hCG injection (3.3±1.2 versus 3.5±1.1, respectively) and, but there was significant difference between the CC+hMG group and CC group regarding the total dose of gonadotropins used in ovulation induction (305±23.8 versus 655±192; total IU, respectively) p<0.05.Conclusions: Women undergoing IUI, ovarian stimulation CC combined with hMG, significantly improved the pregnancy and live birth rates as compared to that of CC group. In women undergoing ovarian stimulation and IUI, there are no significant differences in pregnancy and live birth rates among the various stimulation protocols.

scholarly journals Controlled ovarian stimulation should not be preferred for male infertility treated with intrauterine insemination: a retrospective study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yan Tang ◽  
Qian-Dong He ◽  
Ting-Ting Zhang ◽  
Jing-Jing Wang ◽  
Si-Chong Huang ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Pregnancy Rate ◽  
Ovarian Stimulation ◽  
Intrauterine Insemination ◽  
Multiple Pregnancy ◽  
Clinical Pregnancy ◽  
Male Factor Infertility ◽  
Male Factor ◽  
Ovulatory Follicles ◽  
Multiple Pregnancy Rate

Abstract Background Some studies have stated that intrauterine insemination (IUI) with controlled ovarian stimulation (COS) might increase the pregnancy rate, while others suggest that IUI in the natural cycle (NC) should be the first line of treatment. It remains unclear whether it is necessary to use COS at the same time when IUI is applied to treat isolated male factor infertility. Thus, we aimed to investigate efficacy of IUI with COS for isolated male factor infertility. Methods A total of 601 IUI cycles from 307 couples who sought medical care for isolated male factor infertility between January 2010 and February 2020 were divided into two groups: NC-IUI and COS-IUI. The COS-IUI group was further divided into two subgroups according to the number of pre-ovulatory follicles on the day of HCG: cycles with monofollicular development (one follicle group) and cycles with at least two pre-ovulatory follicles (≥ 2 follicles group). The IUI outcomes, including clinical pregnancy, live birth, spontaneous abortion, ectopic pregnancy, and multiple pregnancy rates were compared. Results The clinical pregnancy, live birth, spontaneous abortion, and ectopic pregnancy rates were comparable between the NC-IUI and COS-IUI group. Similar results were also observed among the NC-IUI, one follicle, and ≥ 2 follicles groups. However, with respect to the multiple pregnancy rate, a trend toward higher multiple pregnancy rate was observed in the COS-IUI group compared to the NC-IUI group (8.7% vs. 0, P = 0.091), and a significant difference was found between the NC-IUI and ≥ 2 follicles group (0 vs. 16.7%, P = 0.033). Conclusion In COS cycles, especially in those with at least two pre-ovulatory follicles, the multiple pregnancy rate increased without a substantial gain in overall pregnancy rate; thus, COS should not be preferred in IUI for isolated male factor infertility. If COS is required, one stimulated follicle and one healthy baby should be the goal considering the safety of both mothers and foetuses.

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.

scholarly journals Effects of Letrozole-HMG and Clomiphene-HMG on Incidence of Luteinized Unruptured Follicle Syndrome in Infertile Women Undergoing Induction Ovulation and Intrauterine Insemination: A Randomised Trial

2015 ◽  
Vol 8 (4) ◽  
pp. 244 ◽  
Author(s):  
Azra Azmoodeh ◽  
Mansoureh Pejman Manesh ◽  
Firouzeh Akbari Asbagh ◽  
Azizeh Ghaseminejad ◽  
Zeinab Hamzehgardeshi
Keyword(s):  
Menstrual Cycle ◽  
Endometrial Thickness ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Randomised Trial ◽  
Induction Of Ovulation ◽  
Infertile Women ◽  
Significant Difference ◽  
Preovulatory Follicles ◽  
Luteinized Unruptured Follicle

<p><strong>BACKGROUND: </strong>Luteinized unruptured follicle (LUF) syndrome is considered a cause of ovulation failure and a subtle cause of infertility. Preovulatory injection of human chorionic gonadotropin (HCG) prevents or treats LUF syndrome, but it has also occurred after the induction of ovulation with clomiphene/HMG and HCG. This study was designed for evaluation and comparison of LUF incidence in eligible infertile women undergoing two stimulation protocols (clomiphene + HMG<strong> </strong>and letrozole + HMG) in addition to intrauterine insemination (IUI). Some related factors were compared between LUF and non-LUF cycles as secondary outcomes.</p> <p><strong>METHODS:</strong> The study was designed as a prospective randomized controlled trial. Patients were randomized using a table of random numbers into two equal protocol groups.<strong> </strong>For group A, (n = 90) clomiphene citrate was administrated orally in doses of 100 mg/day, and group B (n = 90) orally received letrozole 5 mg/day from day 3 to 7 of the menstrual cycle. Then HMG 75IU/day was administered intramuscularly in both groups on day 8 of the menstrual cycle and the dose was adjusted on the basis of ovarian response. The optimum size of preovulatory follicles for the injection of HCG (10,000 IU) was considered 18–23 mm. The number and size of preovulatory follicles were assessed by vaginal ultrasound 12 h before HCG (D0). Endometrial thickness was measured as well. IUI was performed on all patients 38–40 h after HCG. The second ultrasound examination was performed to observe the evidence of oocyte releasing at the time of IUI (D1). If the follicles were unruptured,<strong> </strong>a<strong> </strong>third sonography was performed on day 7 after HCG (D7) to observe LUF syndrome.</p> <p><strong>RESULTS: </strong>There was a significant difference between clomiphene-HMG and letrozole-HMG in LUF (p = 0.021) and pregnancy (p = 0.041). The complete LUF in letrozole-HMG was lower than the alternative group and the pregnancy rate was higher. The patients in the non-LUF group had higher midluteal progesterone and a thicker endometrium compared to LUF cycles (p = 0.039) and (p &lt; 0.001). The results of our multivariate logistic regression indicate that size 18–19.9 mm leads to the complete LUF  less than ≥22 mm [AOR: 0.25, P = 0.005], and  in size 20– 21.9 mm  as well [AOR: 0.17, P = 0.002].</p> <p><strong>CONCLUSION: </strong>Letrozole, with lower incidences of LUF, is more effective than clomiphene citrate for the induction of ovulation in IUI cycles. In our study, we illustrated that larger follicles of ≥22 mm diameter were associated with higher incidences of LUF. We recommend that further studies investigate and focus on the relationship between follicular size and/or full hormonal profiles and LUF.<strong></strong></p>

scholarly journals Study on Pregnancy Outcomes in Intrauterine Insemination Cycles with Motile Spermatozoa Insemination

2020 ◽  
Vol 19 (2) ◽  
pp. 41-45
Author(s):  
Mafruha Khanam ◽  
Rokeya Begum ◽  
Aditi Banerjee ◽  
Jesmin Jerin ◽  
Mohamed Mazih Fazyl ◽  
...  
Keyword(s):  
Success Rate ◽  
Endometrial Thickness ◽  
Intrauterine Insemination ◽  
Semen Analysis ◽  
Male Partner ◽  
Male Factor ◽  
Minimum Thickness ◽  
Successful Pregnancy ◽  
Multiple Variables ◽  
A Prospective Study

Background: Intrauterine Insemination (IUI) is one of the most common assisted reproductive technology methods in the world to treat various forms of infertility. The influence of number of IUI applied with the percentage of motile spermatozoa during insemination is critical on the likelihood of a successful pregnancy. The aim of our study is to assess the results of IUI as a function of the number of IUI applied with motile spermatozoa inseminated during intrauterine insemination in couples with infertility. Materials and methods: This is a prospective study conducted in Surgiscope Fertility Centre, Chattogram, Bangladesh over 21 months on 596 couples who underwent IUI from 01/12/2017 to 30/09/2019. We performed semen analysis of the male partner from the couples who underwent IUI, calculated the sperm motility and the relationship between number of IUI applied with motile spermatozoa and the pregnancy rate of IUI. Multiple variables were selected such as, patient parameters like age of female, number of IUI, percentage of motile spermatozoa inseminated, endometrial thickness and ovulation induction protocol which were recorded and statistically analyzed. Results: Among the 596 patients, the overall success rate was 11%. The maximum number of successes were observed in patients with 3 IUI applications whereas the success rate was lower in comparison with decreasing IUI applications. The regression between the success and number of insemination and age indicate that there is a statistically significant positive relationship between number of inseminations completed and the rate of successful pregnancy, but no significant relationship between the number of prewash sperm and successful pregnancy. These could be due to lower population size. As an ovulation inducing agent, a 12.42% success rate was observed among the patients administered with FSH whereas 9.28% was observed for patients administered with GONAL F. The mean endometrial thickness was observed to be 8.914 mm with a minimum thickness of 4.5 mm and a maximum thickness of 19 mm. Conclusion: The rationale for the use of insemination is to increase gamete density at the site of fertilization. This revealed that intrauterine insemination should be a firstchoice treatment rather than more invasive and expensive techniques of assisted reproduction in cases of cervical, unexplained and moderate male factor subfertility. Chatt Maa Shi Hosp Med Coll J; Vol.19 (2); July 2020; Page 41-45

scholarly journals A study on outcome of controlled ovarian hyperstimulation and intrauterine insemination (husband) in a medical college in Kolkata

2022 ◽  
Vol 13 (1) ◽  
pp. 136-141
Author(s):  
Rajib Roy ◽  
Agniv Sarkar ◽  
Bibhas Saha Dalal
Keyword(s):  
Success Rate ◽  
Ovulation Induction ◽  
Positive Impact ◽  
Endometrial Thickness ◽  
Intrauterine Insemination ◽  
Controlled Ovarian Hyperstimulation ◽  
Infertile Couple ◽  
P Value ◽  
Ovarian Hyperstimulation ◽  
Resource Setting

Background: A combination of controlled ovarian hyperstimulation and intrauterine insemination (IUI) remains an important treatment option for couple having infertility. Success rate of IUI with ovulation induction ranges from 8-20% depending on many factors. Aims and Objectives: To assess the factors affecting the success rate of IUI and to evaluate the success of ovulation Induction by different methods of controlled stimulation protocol. Materials and Methods: It is a duration-based prospective cross-sectional study where total of 67 couples were included by inclusion and exclusion criteria. They underwent 90 cycles of IUI with each couple having a maximum of three cycles. Ovulation induction was done by clomiphene citrate or letrozole or gonadotrophins. Semen preparation was done by density gradient method. The outcomewas measured by positive urine pregnancy test. Range, percentage, confidence interval, mean with standard deviation, median, range, and P-value were calculated. P<0.05 was taken as statistically significant. Results: Out of 90 IUI cycles 8 were successful resulting in a success rate of 8.8% per cycle and 11.9% per couple. Factors that had a positive impact were follicle size >21 sqmm, endometrial thickness >9 mm, post wash count >15 million/ml, >2 cycles of IUI and on the number of follicles 2 or more on the day of trigger. Conclusion: The study concluded that IUI after ovulation induction can be a simple and safe cost-effective procedure in selected group of infertile couple. Clinical significance IUI following ovulation induction can be a successful approach for specific indications in a low-resource setting where options for other ART interventions are absent or limited.

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