Minimal stimulation IVF using clomiphene citrate and oral contraceptive pill pretreatment for LH suppression.
OBJECTIVE
To determine if oral contraceptive pill (OC) pre-treatment prior to minimal stimulation IVF using clomiphene citrate (CC) would make the procedure easier to perform by preventing the LH surge and result in pregnancy rates (PRs) comparable to stimulated IVF.


METHODS
Prospective cohort study.


METHODS
Private tertiary infertility center.


METHODS
Thirty-two women with tubal or pelvic adhesive disease as the cause of their infertility, ovulatory cycles, under the age of 40, and no male factor.


METHODS
Two-month ovarian-hypothalamic-pituitary axis suppression with OC followed by CC 100 mg on day 3 of the cycle for 8 days, hCG administration midcycle, follicle aspiration, IVF, and embryo transfer.


METHODS
Oocytes retrieved, serum LH and estradiol levels, maturity of oocytes, fertilization rates, embryo number and quality, and PRs.


RESULTS
Thirty-six patients completed 71 stimulation cycles and 64 follicle aspirations. No LH surges occurred with a mean mature oocytes retrieved of 3.2, 90% fertilization rate, and mean 2.5 embryos transferred. Twenty-one of the 64 cycles resulted in a clinical pregnancy (32.8% PR per retrieval) with 2 other biochemical pregnancies and 3 twin gestations. This was not significantly different from the matched cohort stimulated IVF.


CONCLUSIONS
Minimal stimulation IVF is a simple, low-cost, and low-risk alternative to stimulated IVF with comparable PRs.
Branigan
E F
EF
Bellingham IVF and Infertility Center, Bellingham, Washington, USA.
Estes
M A
MA
D000328:Adult; D001548:Benzalkonium Compounds / Q000008:administration & dosage; D016009:Chi-Square Distribution; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D002996:Clomiphene / Q000008:administration & dosage*; D015331:Cohort Studies; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage*; D004624:Embryo Transfer; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy; D007986:Luteinizing Hormone / Q000187:drug effects* / Q000378:metabolism; D009865:Oocytes / Q000187:drug effects / Q000502:physiology; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies
D001548:Benzalkonium Compounds; D006063:Chorionic Gonadotropin; D003278:Contraceptives, Oral, Hormonal; D005300:Fertility Agents, Female; D002996:Clomiphene; C030547:toloconium methylsulfate; D007986:Luteinizing Hormone