scholarly journals Effectiveness of Letrozole and Human Chorionic Gonadotropin Injection in Ovulation Induction: A Cohort Study

2021 ◽  
Author(s):  
Peter Chukwudi Udealor ◽  
Eric Ezenwa Asimadu ◽  
Emeka Iloghalu
Keyword(s):  
Cohort Study ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Ovulation Induction ◽  
Intrauterine Insemination ◽  
Statistical Significance ◽  
Pregnancy Rates ◽  
Significant Difference ◽  
Ovulation Stimulation ◽  
Group A

Introduction: Ovulation stimulation followed by timed intercourse or Intrauterine Insemination (IUI) is widely used for treatment of anovulatory infertility. Aim: To compare the effectiveness of Letrozole (LE) alone versus LE and human chorionic gonadotropin injection in ovulation induction and pregnancy rates in women undergoing ovulation induction/follicular tracking in Enugu, Nigeria. Materials and Methods: The longitudinal cohort study was carried out in University of Nigeria Teaching Hospital and Livingston Specialist Gynaecological Hospital in Enugu, Nigeria. Study population were women coming for ovulation stimulation/follicular tracking. Ovulation was confirmed by ultrasound evidence of ovulation with a progesterone level of greater or equal to 25 nmol/L on day 21, positive pregnancy test/ultrasound detection of a gestational sac. Patients were consecutively assigned to group A or B. Group A received LE only for the induction while group B received 10000 IU of human chorionic gonadotropin injection in addition to LE. A total of 5 mg of LE was given daily from day 3 to day 7. The primary outcome measured was the number of ruptured/crenated follicles on either arm while the secondary outcomes were the number of Luteinised Unruptured Follicles (LUF) and pregnancy rates. The Statistical analysis was performed using the Statistical Package for the Social Sciences version 21.0 software (SPSS Inc., Chicago, IL, United States). Results: A total of 50 women were in each arm of the study. There was no significant difference in age and parity between the two arms. There was no significance difference between the period of infertility and the number of the previous cycles of ovulation stimulation. (p=0.444 and 0.526, respectively). Ovulation was significantly associated with HCG injection (p=0.001). However, there was no statistical significance between both arms regarding the number of LUF (p=0.216). HCG injection was significantly associated with pregnancy. Subjects who took HCG injection were over two times more likely to become pregnant than those without HCG injection (OR=2.488, 95% CI for OR=1.057-5.857, p=0.037). Conclusion: This study showed that both the ovulation rate and pregnancy rate are significantly improved when human chorionic gonadotrophin injection is given after ovarian stimulation.

scholarly journals Effectiveness of highly purified HMG plus r-FSH vs r-FSH alone vs r-FSH plus r-LH in IVF-ET/ ICSI patients：a retrospective cohort study

2020 ◽  
Author(s):  
Zhong-Kai Wang ◽  
She-ling Wu ◽  
Xiao-Na Yu ◽  
Hong-Wu Qiao ◽  
Hua Lou ◽  
...  
Keyword(s):  
Cohort Study ◽  
Subgroup Analysis ◽  
Retrospective Cohort Study ◽  
Ovulation Induction ◽  
Retrospective Cohort ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Current Standard ◽  
Significant Difference ◽  
Clinical Pregnancy Rates

Abstract Objective: To evaluate the effectiveness of highly purified human menopausal gonadotropins (hp-HMG) plus recombinant follicle stimulating hormone (r-FSH) vs r-FSH vs r-FSH plus recombinant luteinizing hormone （r-LH） in vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) patients。Design :Retrospective cohort studyMethods:This was a retrospective study. Among a total number of 3568 patients who had undergone IVF/ICSI applications, 409 eligible patients were included.Total units of follitropin alpha preparations used in ovulation induction, total number of meiois-2 phase oocytes, total number of used oocytes in ICSI cycle, fertilization rate and clinical pregnancy rates of both groups were analyzed. In this retrospective cohort study, women undergoing IVF/ICSI Gonadotropin releasing hormone (GnRH) antagonist cycles downregulation. 409 patients were included in the study. Among them One group followed the current standard protocol of no LH or hp-HMG supplementation given(n=64). The other had LH supplementation in the form of r -LH (Luveris; Merck Serono, Switzerland) (n=221), Another group had hp-HMG supplementation in the form of hp-HMG (Menopur , Ferring,Germany)(n=121).In the Subgroup analysis were decided by AFC ,7 < AFC〈20 or AFC>20 of the three group.Result: Mean duration of stimulation and was longer in the group of patients treated with hp-HMG plus rFSH compared to the group of patients treated with r-FSH and the group of r-LH plus r-FSH (13.24 days and 12.72days and12.21days, respectively; P<0.05). The amount of GN does for patients treated withhp-HMG plus rFSH compared to the group of patients treated with r-FSH plus r-LH and the group of r-FSH alone respectively (P<0.05). Clinical pregnancy rates were 76.6% and 60.9% and 62.9% （P<0.05）in the groups of patients treated with hp-hMG plus rFSH, r-FSH plus r-LH,r-FSHalonerespectively. What’s morea greater live birth rate was noted in the hp-hMG plus r-FSH group, there was statistically significant difference between the three groups (P>0.05).in the subgroup analysis when AFC>20 hp-HMG plus rFSH group have more lower ovarian hyperstimulation syndrome （OHSS） than r-FSH plus r-LH and rFSH alone,respectively.Clonclusion:The higher oocyte yield with r-FSH does not result in higher quality embryos.hp-HMG or r-LH supplementation is an option for improving IVF outcome in patients ovulation induction with r-FSH during GnRH agonist down-regulation. Particularly, hp-HMG is recommended as it may have a beneficial action on implantation in selected group especially AFC more than 20patients.

scholarly journals Comparing the Effectiveness of Doing Intra-uterine Insemination 36 and 42 Hours after Human Chorionic Gonadotropin (HCG) Injection on Pregnancy Rate: A Randomized Clinical Trial

2020 ◽  
Author(s):  
Mahboubeh Firouz ◽  
Narjes Noori ◽  
Marzieh Ghasemi ◽  
Alireza Dashipour ◽  
Narjes Keikha
Keyword(s):  
Clinical Trial ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Intrauterine Insemination ◽  
Uterine Cavity ◽  
Female Reproductive Tract ◽  
Control Group ◽  
Case Group ◽  
Significant Difference ◽  
Intra Uterine Insemination

Objective: Intrauterine insemination (IUI) is an assisted conception technique that involves the deposition of a processed semen sample in the upper uterine cavity, overcoming natural barriers to sperm ascent in the female reproductive tract. Hence, we compared the results of doing intra-uterine insemination 36 and 42 hours after human chorionic gonadotropin (hCG) hormone injection to achieve clinical and chemical pregnancy rates. Materials and methods: One hundred and sixty infertile women with unexplained infertility participated in this clinical trial. They were divided into two groups: those who underwent IUI 36 hours after hCG injection (control group), and those who underwent IUI 42 hours after hCG injection (case group). Statistical analyses were done using IBM-SPSS 25.0. and Chi-square test were used for data analysis. Results: The percentages of clinical and chemical pregnancies were significantly higher in the 42h group compared to the other group (P = 0.038 vs. P = 0.009, respectively). There was no significant difference regarding frequency of abortion, twin and ectopic pregnancies between the two groups (P > 0.05). Conclusion: Doing IUI 42 hours after hCG injection can significantly increase chances of fertility compared to doing it 36 hours after hCG injection.

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