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著者: Dickey RP, Taylor SN, Lu PY, Sartor BM, Rye PH, Pyrzak R.
雑誌名: Fertil Steril. 2002 Nov;78(5):1088-95. doi: 10.1016/s0015-0282(02)04212-7.
Abstract/Text
OBJECTIVE: To determine how diagnosis, age, sperm quality, and number of preovulatory follicles affect pregnancy rates when multiple cycles of clomiphene citrate (CC)-IUI are performed.
DESIGN: Fifteen-year prospective observational study.
SETTING: Private infertility clinic.
PATIENT(S): Three thousand, three hundred eighty-one cycles of husband or donor IUI.
INTERVENTION(S): Ovulation induction with CC and IUI.
MAIN OUTCOME MEASURE(S): Per-cycle pregnancy rate (PR), cumulative pregnancy rate (CPR).
RESULT(S): Pregnancy rates remained constant through four cycles, then fell significantly for diagnoses other than ovulatory dysfunction. Mean PRs for cycles 1-4 were significantly lower for patients with the following characteristics: age >/=43 years, poor semen quality, single preovulatory follicles, and diagnoses other than ovulatory dysfunction. Additional cycles of CC-IUI compensated for low PRs because of age, semen quality, or number of follicles. After four cycles, CPRs were 46% for ovulatory dysfunction; 38% for cervical factor, male factor, and unexplained infertility; 34% for endometriosis; and 26% for tubal factor. After six cycles, CPRs were 65% for ovulation dysfunction, 35% for endometriosis, and unchanged for other diagnoses.
CONCLUSION(S): Clomiphene citrate-intrauterine insemination should be performed for a minimum of four cycles. Additional cycles of CC-IUI can compensate for low pregnancy rates due to age, semen quality, or follicle number in patients with ovulation dysfunction.
PMID 12413999 Fertil Steril. 2002 Nov;78(5):1088-95. doi: 10.1016/s0015-0282(02)04212-7.
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