Volume 12, Issue 7 (8-2014)                   IJRM 2014, 12(7): 493-0 | Back to browse issues page

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Isa A M, Abu-Rafea B, Al-Asiri S, Al-Motawa J. Ovarian stimulation medications and patients’ responses as prognostic factors in IUI-treated infertile Saudi patients. IJRM 2014; 12 (7) :493-0
URL: http://ijrm.ir/article-1-561-en.html
Ovarian stimulation medications and patients’ responses as prognostic factors in IUI-treated infertile Saudi patients
Ahmed M. Isa * 1, Basim Abu-Rafea2 , Sahel Al-Asiri2 , Johara Al-Motawa2
1- Assisted Conception Unit, Department of Obstetrics and Gynecology, College of Medicine, King Saud University, Riyadh, Saudi Arabia , isaahmed@hotmail.com
2- Assisted Conception Unit, Department of Obstetrics and Gynecology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
Abstract:   (2950 Views)
Background: Intrauterine Insemination (IUI) remains the first thought of infertility treatment.
Objective: To compare the stimulation effects and Pregnancy rate (PR) outcomes of two ovulation induction (OI) medications, human-derived menopausal gonadotrophins (hMGH), Merional (MER), and recombinant follicular stimulating hormone (rFSH), Puregon (PUR), in a cohort of Saudi infertile patients, for better predictability of treatment results.
Materials and Methods: During a 24-month period, 296 women underwent IUI single treatments. PR’s were correlated with the type of stimulation medication that were prospectively and randomly assigned to each patient, and with the number and size of maturing follicles detected on the hCG injection day.
Results: MER and PUR needed comparable number of days (9.26±4.74 and 9.73±6.27 respectively) before follicles were ready for IUI, although the average amount used from MER, 1199.90 IU, was about double that was used from PUR, 621.08 IU. The overall PR in case of PUR however was nearly double that of MER, 13.28% and 7.14% respectively. The best PR, 16.22%, occurred when the follicles matured within 12-13 days. Three follicles of at least 15-mm diameter on the hCG day had better PR’s than one or two, however when the follicles’ diameters were at least 18-mm, PR was significantly higher, (p=0.013).
Conclusion: MER and PUR had comparable stimulation effects; however PUR had noticeably higher PR. The best PR occurred when the follicles matured within 12-13 days. PR in case of three maturing follicles on the hCG day was better than only one or two, and significantly better when their diameters were at least 18 mm.
Keywords: Artificial Insemination, Ovulation induction, Ovarian Follicles, Pregnancy Rate
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Type of Study: Original Article |
References
1. Ibérico G, Vioque J, Ariza N, Lozano JM, Roca M, Llácer J, et al. Analysis of factors influencing pregnancy rates in homologous intrauterine insemination. Fertil Steril 2004; 81: 1308-1313. [DOI:10.1016/j.fertnstert.2003.09.062]
2. Kossakowski J, Stephenson M, Smith H. Intrauterine insemination with husband's sperm: comparison of pregnancy rates in couples with cervical factor, male factor, immunological factor and idiopathic infertility. Aust N Z J Obstet Gynaecol 1993; 33: 183-186. [DOI:10.1111/j.1479-828X.1993.tb02389.x]
3. Allen NC, Herbert CM 3rd, Maxson WS, Rogers BJ, Diamond MP, Wentz AC. Intrauterine insemination: a critical review. Fertil Steril 1985; 44: 569-580. [DOI:10.1016/S0015-0282(16)48969-7]
4. Nuojua-Huttunen S, Tomas C, Bloigu R, Tuomivaara L, Martikainen H. Intrauterine insemination treatment in subfertility: an analysis of factors affecting outcome. Hum Reprod 1999; 14: 698-703. [DOI:10.1093/humrep/14.3.698]
5. Gezginç K, Görkemli H, Celik C, Karatayli R, Ciçek MN, Olakoglu MC. Comparison of single versus double intrauterine insemination. Taiwan J Obstet Gynecol 2008; 7: 57-61. [DOI:10.1016/S1028-4559(08)60055-8]
6. Demirol A, Gurgan T. Comparison of different gonadotrophin preparations in intrauterine insemination cycles for the treatment of unexplained infertility: a prospective, randomized study. Hum Reprod 2007; 22: 97-100. [DOI:10.1093/humrep/del335]
7. Freour T, Jean M, Mirallie S, Langlois ML, Dubourdieu S, Barriere P. Predictive value of CASA parameters in IUI with frozen donor sperm. Int J Androl 2009: 498-504. [DOI:10.1111/j.1365-2605.2008.00886.x]
8. Petanoveski Z, Dimitrov G, Avdin B, Hadzi-Lega M, Sotirovska V, Suslevski D, et al. Recombinant FSH versus HP-HMG for controled ovarian stimulation in intracitoplasmic sperm injection cycles. Med Arh 2011; 65: 153-156. [DOI:10.5455/medarh.2011.65.153-156]
9. Henk JOut, Bernadette MJL, Mannaerts, Stefan G.A.J.Driessen, and Herjan J.T. Coelingh Bennink. Recombinant follicle stimulating hormone (rFSH; PUR) in assisted reproduction: More oocytes, more pregnancies. Results from five comparative studies. Hum Reprod Update 1996; 2: 162-171. [DOI:10.1093/humupd/2.2.162]
10. Kocak M, Dilbaz B, Demir B, Taşci Y, Tarcan A, Dede S, Haberal A. Lyophilised hMG versus rFSH in women with unexplained infertility undergoing a controlled ovarian stimulation with intrauterine insemination: a prospective, randomised study. Gynecol Endocrinol 2010; 26: 429-434. [DOI:10.3109/09513591003632175]
11. Sagnella F, Moro F, Lanzone A, Tropea A, Martinez D, Capalbo A, et al. A prospective randomized noninferiority study comparing recombinant FSH and highly purified menotropin in intrauterine insemination cycles in couples with unexplained infertility and/or mild-moderate male factor. Fertil Steril 2011; 95: 689-694. [DOI:10.1016/j.fertnstert.2010.08.044]
12. Khalil MR, Rasmussen PE, Erb K, Laursen SB, Rex S, Westergaard LG. Homologous intrauterine insemination. An evaluation of prognostic factors based on a review of 2473 cycles. Acta Obstet Gynecol Scand 2001; 80: 74-81. [DOI:10.1080/791201839]
13. Zadehmodarres S, Oladi B, Saeedi S, Jahed F, Ashraf H. Intrauterine insemination with husband semen: an evaluation of pregnancy rate and factors affecting outcome. J Assist Reprod Genet 2009; 26: 7-11. [DOI:10.1007/s10815-008-9273-7]
14. Rawal N, Drakeley A, Haddad N. Intrauterine insemination practice in the UK. J Obstet Gynaecol 2008; 28: 738-741. [DOI:10.1080/01443610802461789]
15. Ahinko-Hakamaa K, Huhtala H, Tinkanen H. Success in intrauterine insemination: the role of etiology. Acta Obstet Gynecol Scand 2007; 86: 855-860. [DOI:10.1080/00016340701416895]
16. Merviel P, Heraud MH, Grenier N, Lourdel E, Sanguinet P, Copin H. Predictive factors for pregnancy after intrauterine insemination (IUI): an analysis of 1038 cycles and a review of the literature. Fertil Steril 2010; 93: 79-88. [DOI:10.1016/j.fertnstert.2008.09.058]
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