Relationship of follicle number and other factors to fecundability and multiple pregnancy in clomiphene citrate-induced intrauterine insemination cycles.
OBJECTIVE
To determine characteristics associated with pregnancy and multiple gestation after clomiphene citrate (CC)-intrauterine insemination (IUI).


METHODS
Prospective study of all patients undergoing CC-IUI between January 1, 1983 and December 31, 1989.


METHODS
Private fertility clinic.


METHODS
Eight hundred forty-nine patients undergoing 1,974 cycles of CC-IUI.


METHODS
Relationship between number and size of preovulatory follicles, age, additional infertility diagnosis, medication, and initial semen quality to fecundity, birth, and multiple gestation.


RESULTS
Uncorrected, per cycle fecundity was 7.2%. The number of follicles greater than or equal to 12 mm (r = 0.055, P less than 0.05) was and the number greater than or equal to 15, 18, and 21 mm was not correlated with fecundity. Endometriosis with (P = 0.013) or without (P less than 0.0005) tubal adhesions and tubal adhesions alone (P = 0.005), decreased fecundability by 50%. Initial semen quality did not affect fecundity, unless semen concentration was less than 5 x 10(6)/mL or motility was less than 20%. Multiple pregnancy was not associated with the dose of CC, use of human chorionic gonadotropin, or number of follicles.


CONCLUSIONS
Multiple pregnancy was unrelated to follicle numbers or to CC dose. The highest birth rates after CC-IUI occurred when initial sperm concentration was greater than or equal to 5 x 10(6)/mL, motility was greater than or equal to 20%, and no endometriosis or adhesions were present.
Dickey
R P
RP
Department of Obstetrics and Gynecology, Fertility Institute of New Orleans, Louisiana 70128.
Olar
T T
TT
Taylor
S N
SN
Curole
D N
DN
Rye
P H
PH
D002996:Clomiphene / Q000627:therapeutic use*; D005260:Female; D005298:Fertility; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy; D007317:Insemination, Artificial, Homologous; D006080:Ovarian Follicle / Q000502:physiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D011446:Prospective Studies; D012044:Regression Analysis
D002996:Clomiphene