title: Low multiple pregnancy rates and reduced frequency of cancellation after ovulation induction with gonadotropins, if eventual supernumerary follicles are aspirated to prevent polyovulation.
abstract: OBJECTIVE
  Our purpose was to demonstrate the feasibility of the routine aspiration of supernumerary follicles in infertile patients with imminent polyovulation after ovulation induction with gonadotropins and to examine its effect on the frequency of cycle cancellation and on the (multiple) pregnancy rate.
  
  
  METHODS
  The data on 796 treatment cycles, performed between 1989 and 1996 on 410 infertile couples, were analyzed retrospectively. From October 1992, whenever necessary, supernumerary ovarian follicles were selectively aspirated transvaginally under ultrasound guidance to prevent the ovulation of more than three follicles. Thereafter, intrauterine insemination was performed.
  
  
  RESULTS
  After the adoption of transvaginal ultrasound-guided aspiration of supernumerary follicles into the treatment protocol in October 1992, the number of canceled cycles (P < 0.0001) and the multiple pregnancy rate (P < 0.01) were significantly reduced compared to those previously. The overall pregnancy rate remained stable. No ovarian hyperstimulation syndrome requiring hospitalization was noted, and no complications resulting from the follicle aspiration were registered.
  
  
  CONCLUSIONS
  Transvaginal ultrasound-guided aspiration of supernumerary ovarian follicles increases both the efficacy and the safety of ovulation induction with gonadotropins. Because of the limited equipment required, this method represents an alternative for conversion of overstimulated cycles to more costly alternatives such as in vitro fertilization.
authors.affiliation: Woman's Hospital of the University, Münster, Germany.
authors.forename: C
authors.initials: C
authors.lastname: De Geyter
authors.forename: M
authors.initials: M
authors.lastname: De Geyter
authors.forename: E
authors.initials: E
authors.lastname: Nieschlag
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use; D006062:Gonadotropins / Q000494:pharmacology*; D006801:Humans; D007247:Infertility, Female / Q000473:pathology / Q000628:therapy; D007248:Infertility, Male / Q000473:pathology / Q000628:therapy; D007317:Insemination, Artificial, Homologous; D008186:Luteolytic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D006080:Ovarian Follicle / Q000502:physiology* / Q000601:surgery; D010062:Ovulation Induction; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple / Q000187:drug effects / Q000502:physiology* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013396:Suction; D013480:Superovulation / Q000502:physiology*; D017329:Triptorelin Pamoate / Q000627:therapeutic use
chemical_list: D006062:Gonadotropins; D008186:Luteolytic Agents; D017329:Triptorelin Pamoate; D005640:Follicle Stimulating Hormone