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Minimal stimulation using gonadotropin combined with clomiphene citrate or letrozole for intrauterine insemination

 Bo Hyon Yun  ;  Seung Joo Chon  ;  Joo Hyun Park  ;  Seok Kyo Seo  ;  SiHyun Cho  ;  Young Sik Choi  ;  Seok Hyun Kim  ;  Byung Seok Lee 
 YONSEI MEDICAL JOURNAL, Vol.56(2) : 490-496, 2015 
Journal Title
Issue Date
Adult ; Aromatase Inhibitors/administration & dosage ; Clomiphene/administration & dosage* ; Clomiphene/therapeutic use ; Drug Administration Schedule ; Drug Combinations ; Female ; Fertility Agents, Female/administration & dosage ; Fertility Agents, Female/therapeutic use ; Fertilization in Vitro ; Gonadotropins/administration & dosage* ; Humans ; Infertility, Female/drug therapy* ; Insemination, Artificial/statistics & numerical data* ; Nitriles/administration & dosage* ; Ovulation Induction/methods ; Ovulation Induction/statistics & numerical data* ; Pregnancy ; Pregnancy Rate ; Treatment Outcome ; Triazoles/administration & dosage*
Intrauterine insemination ; clomiphene citrate ; gonadotropin ; letrozole ; minimal stimulation
PURPOSE: To evaluate the efficacy of minimal stimulation using discretely administered gonadotropin combined with clomiphene citrate (CC) or letrozole (LTZ) for intrauterine insemination (IUI) cycles. MATERIALS AND METHODS: Total 257 IUI cycles from 158 infertile couples were assessed. A CC dose of 100 mg/day (n=126 cycles) or a LTZ dose of 5 mg/day (n=131 cycles) was administered on days 3-5 of the menstrual cycle for 5 days. Each group received human menopausal gonadotropin at a dose of 150 IU by two or three alternative day: CC combined with alternate-day regimen for 2 or 3 days (CC+300, n=37; CC+450, n=89) and LTZ combined with alternate-day regimen for 2 or 3 days (LTZ+300, n=36; LTZ+450, n=95). RESULTS: The clinical pregnancy rate was comparable between the CC and LTZ groups (18.3% vs. 13.0%, p=0.243). The clinical pregnancy rate also showed no significant difference among the 4 groups (21.6% vs. 16.9% vs. 11.1% vs. 12.6%, p=0.507). The multiple pregnancy rate was significantly higher in LTZ compared to CC group (37.5% vs. 8.7%, p=0.028) and in the LTZ+450 compared to CC+450 group (50% vs. 13.3%, p=0.038). Overall, there were 15 cases of ovarian hyperstimulation syndrome (OHSS), with the prevalence being significantly lower in the LTZ compared to CC group (1.5% vs. 10.3%, p=0.003). OHSS was more prevalent in the CC+450 compared to the LTZ+450 group (12.4% vs. 1.1%, p=0.002). CONCLUSION: Our findings suggest that minimal stimulation using two alternate-day gonadotropin with LTZ decreases the development of OHSS and multiple pregnancies, while maintaining comparable pregnancy rates in IUI cycles.
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1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Park, Joo Hyun(박주현)
Seo, Seok Kyo(서석교) ORCID logo https://orcid.org/0000-0003-3404-0484
Yun, Bo Hyon(윤보현) ORCID logo https://orcid.org/0000-0001-5703-797X
Lee, Byung Seok(이병석) ORCID logo https://orcid.org/0000-0001-6001-2079
Chon, Seung Joo(전승주)
Cho, Si Hyun(조시현) ORCID logo https://orcid.org/0000-0003-2718-6645
Choi, Young Sik(최영식) ORCID logo https://orcid.org/0000-0002-1157-4822
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