Choice of an ovarian stimulation protocol according to the follicular puncture method in an in vitro fertilization programme.
In order to ascertain the adequacy of ovarian stimulation protocols with a type of follicular puncture, 126 women undergoing in vitro fertilization received either combination clomiphene/hMG or hMG alone according to a randomized test protocol. Within both groups patients for whom a pelvic examination was required had laparoscopies, while others had transvaginal ultrasonically guided punctures as far as possible. Clomiphene/hMG was more efficient than hMG alone as assessed from the cleavage rate (68% vs. 54%; p less than 0.01) and the pregnancy per attempt rate (16% vs. 5%; p less than 0.05). Laparoscopic punctures were more efficient than ultrasonically guided punctures (mean number of recovered oocytes: 4.8 +/- 2.6 vs. 3 +/- 2.5; p less than 0.001), but slightly better results were achieved by this latter method in ongoing pregnancy per puncture rate (18% vs. 8%; NS). With ultrasonically guided punctures, stimulation by clomiphene/hMG allowed better oocyte recoveries (3.8 +/- 2.5 vs. 2.3 +/- 1.9, p less than 0.05). Such results constitute an argument for preferential use of the clomiphene/hMG stimulation protocol with ultrasonically guided punctures.
D002996:Clomiphene / Q000008:administration & dosage; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008596:Menotropins / Q000008:administration & dosage; D009865:Oocytes; D006080:Ovarian Follicle; D010062:Ovulation Induction / Q000379:methods*; D011677:Punctures / Q000379:methods
D002996:Clomiphene; D008596:Menotropins