Fertility and sterility · 2007
The additional value of ovarian hyperstimulation in intrauterine insemination for couples with an abnormal postcoital test and a poor prognosis: a randomized clinical trial.
СтатьяМногоцентровое исследованиеРандомизированное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Steures Pieternel, van der Steeg Jan Willem, Hompes Peter G A, Bossuyt Patrick M M, Habbema J Dik F, Eijkemans Marinus J C, Koks Caroline A M, Boudrez Petra, van der Veen Fulco, Mol Ben W J
Аннотация
OBJECTIVE: To assess the effectiveness of controlled ovarian hyperstimulation (COH) in intrauterine insemination (IUI) for subfertile couples with an abnormal postcoital test and a poor prognosis.
DESIGN: Randomized clinical trial.
SETTING: Twenty-four fertility centers in the Netherlands.
PATIENT(S): Subfertile couples with a well-timed nonprogressive PCT and additional factors that reduce fertility.
INTERVENTION(S): Couples were randomly allocated to three cycles of IUI with COH or three cycles of IUI without COH.
MAIN OUTCOME MEASURE(S): Ongoing pregnancy within three IUI cycles.
RESULT(S): We randomly allocated 132 couples to IUI with COH, and 133, to IUI without COH. We observed 33 pregnancies (25%) in the couples allocated to IUI with COH, of which 28 were ongoing (21%), vs. 28 pregnancies (21%) in the couples allocated to IUI without COH, of which 23 were ongoing (17%; relative risk of an ongoing pregnancy, 1.2; 95% confidence interval, 0.75 to 2.0). Two multiple pregnancies occurred in the IUI with COH group, and one, in the IUI without COH group.
CONCLUSION(S): In couples with an abnormal PCT and a poor prognosis, IUI with COH leads to pregnancy rates comparable to those for IUI without COH. We propose to perform IUI without COH in couples with an abnormal PCT.
DESIGN: Randomized clinical trial.
SETTING: Twenty-four fertility centers in the Netherlands.
PATIENT(S): Subfertile couples with a well-timed nonprogressive PCT and additional factors that reduce fertility.
INTERVENTION(S): Couples were randomly allocated to three cycles of IUI with COH or three cycles of IUI without COH.
MAIN OUTCOME MEASURE(S): Ongoing pregnancy within three IUI cycles.
RESULT(S): We randomly allocated 132 couples to IUI with COH, and 133, to IUI without COH. We observed 33 pregnancies (25%) in the couples allocated to IUI with COH, of which 28 were ongoing (21%), vs. 28 pregnancies (21%) in the couples allocated to IUI without COH, of which 23 were ongoing (17%; relative risk of an ongoing pregnancy, 1.2; 95% confidence interval, 0.75 to 2.0). Two multiple pregnancies occurred in the IUI with COH group, and one, in the IUI without COH group.
CONCLUSION(S): In couples with an abnormal PCT and a poor prognosis, IUI with COH leads to pregnancy rates comparable to those for IUI without COH. We propose to perform IUI without COH in couples with an abnormal PCT.