Comparison of a single dose of follitropin alfa administered before or after clomiphene citrate in the treatment of unexplained infertility.

OBJECTIVE

To evaluate the efficacy of a single 150 international unit (IU) dose of follitropin alfa (FA), administered either before or after clomiphene citrate (CC), in women with unexplained infertility.

METHODS

This prospective interventional study included 105 patients allocated to four groups. Group 1 received CC 100 mg/day on cycle days 3-7. Group 2 received a single 150-IU dose of FA on day 3, followed by CC on days 4-8. Group 3 received CC 100 mg/day on days 3-7, followed by a single 150-IU dose of FA on day 8. Group 4 received only a single 150-IU dose of FA on day 3. The primary outcomes were pregnancy rate (PR) and risk of ovarian hyperstimulation syndrome (OHSS), and the secondary outcome was ovulation rate (OR).

RESULTS

No ovulation was observed in the single-dose FA group. Group 1 had a PR of 11.4%, an OR of 94.3%, and an OHSS risk of 5.7%. Group 2 had a PR of 3.3%, an OR of 80.8%, and an OHSS risk of 13.3%. Group 3 had a PR of 6.7%, an OR of 92.6%, and an OHSS risk of 10%. The OR was significantly higher in the CC group than in the other groups (p=0.022). However, no significant differences were observed among groups in PR or OHSS risk (p>0.05).

CONCLUSION

Adding a single dose of FA before or after CC did not improve treatment success in patients with unexplained infertility.