Probability of success of conservative treatment of infertility: exact timing as an important prognostic factor.

OBJECTIVE

To find out which forms of conservative infertility therapy led to the highest pregnancy rate and which factors influence the occurrence of a pregnancy.

STUDY

DESIGN

A total of 433 conservative treatment cycles were retrospectively evaluated. Ovarian stimulation was performed with clomiphene citrate (CC) or gonadotropins (follicle stimulating hormone [FSH] or human menopausal gonadotropin) with ovulation induction and luteal phase support in some cases. Patients then received intrauterine insemination (IUI) or had timed intercourse (TI).

RESULTS

The pregnancy rates were 2.7% in CC/TI cycles, 8.2% in FSH/TI cycles, 10.3% in CC/IUI cycles, and 15.5% in FSH/IUI cycles. A cycle regulation by means of an ovulation induction and a luteal phase-supporting medication resulted in significantly higher pregnancy rates. When the TI and/or the IUI were carried out postovulatorily and in the case of already beginning endogenous ovulation (increase of the luteinizing hormone value shown in the last control), the success rate was significantly lower.

CONCLUSION

Not only the choice of the optimal form of treatment but also a sufficient supportive medication in terms of an ovulation induction and a luteal phase support as well as exact timing are vital for the treatment success in conservative infertility treatment.