Abstract
Objective: This aim of this study is to assess the ovulation induction cycles based on clomiphene citrate and gonadotropin administration and specify the factors associated with successful outcomes. Study Design: This is a prospective study of 631 patients who underwent 917 ovulation induction cycles. While clomiphene citrate was used in 680 cycles (74.2%) and recombinant follicle-stimulating hormone was administered in 237 cycles (25.8%). Results: A total of 153 pregnancies were achieved in 917 ovulation induction cycles, indicating a clinical pregnancy rate of 16.7%. The ovulation induction cycles which ended up with clinical pregnancy had a significantly lower frequency of smoking (p=0.005), shorter infertility duration (p=0.001), higher basal luteinizing hormone (p=0.021) and lower basal progesterone (p=0.008) than unsuccessful cycles. The clomiphene citrate cycles which ended up with clinical pregnancy had a significantly lower frequency of smoking (p=0.011), shorter infertility duration (p=0.001) and lower basal progesterone (p=0.013) than the unsuccessful cycles. The recombinant follicle-stimulating hormone cycles which ended up with clinical pregnancy had a significantly higher basal luteinizing hormone (p=0.008) than the unsuccessful cycles. Basal luteinizing hormone and progesterone concentrations could significantly distinguish the patients who were able to conceive in ovulation induction cycles (p=0.021 and p=0.008, respectively).Conclusions: Smoking, longer duration of infertility, and elevated basal progesterone are poor prognostic factors for clinical pregnancy in clomiphene citrate and recombinant follicle-stimulating hormone cycles.
Highlights
Infertility is a public health concern that drives many couples to search for the help of assisted reproductive technology (ART) methods
Various success rates have been yielded for various populations of infertile couples, 30% percent of the total pregnancy rates have been reported for ovulation induction cycles followed by intrauterine insemination (IUI) [3,4,5]
Clomiphene citrate was used for ovulation induction in 680 cycles (74.2%), and recombinant follicle-stimulating hormone was administered for ovulation induction in 237 cycles (25.8%)
Summary
Infertility is a public health concern that drives many couples to search for the help of assisted reproductive technology (ART) methods. Fertilization has been addressed as the most successful ART procedure, but it is relatively expensive and less available. Clomiphene citrate (CC) has been traditionally used as the first-line drug for ovulation induction in women with chronic anovulation. Ovarian stimulation aims to achieve multifollicular growth in women with unexplained infertility, mono-follicular growth appears to be sufficient for women who are to undergo ovulation induction due to chronic anovulation. Various success rates have been yielded for various populations of infertile couples, 30% percent of the total pregnancy rates have been reported for ovulation induction cycles followed by IUI [3,4,5]
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