Abstract
Objective To determine the relationship between ovarian follicular response (number and diameter of follicles) to ovulation induction agents and pregnancy. Design Retrospective cohort study. Setting Hospital-based center of reproductive medicine. Patient(s) Three hundred twenty-two clinically diagnosed infertile couples undergoing 1,483 cycles of ovulation induction and IUI. Intervention(s) Oral and injectable fertility drugs were administered for 2–10 cycles; ultrasound follicular measurements were recorded around time of ovulation; hCG was administered when follicles were 18–20 mm or more in diameter; IUI was performed 36–40 hours after administration of hCG. Main outcome measure(s) A first positive pregnancy test as indicative for conception. Result(s) Women with follicular diameters ≥20 mm were less likely to become pregnant as compared to women with diameters between 15.00 and 19.99 mm (risk ratio [RR] = 0.58, 95% confidence interval [CI] = 0.35, 0.97). Women ≥30 years of age were half as likely to become pregnant as compared to women <30 years (RR = 0.51, 95% CI = 0.30, 0.85). Likelihood of pregnancy increased by 21% for each prior pregnancy (RR = 1.21, 95% CI = 1.00, 1.47). Conclusion(s) Maternal age, gravidity, and follicular diameters around the time of insemination are prognostic factors in the likelihood of pregnancy.
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