title: Factors influencing pregnancy rates with a combined clomiphene citrate/gonadotropin protocol for non-assisted reproductive technology fertility treatment.
abstract: OBJECTIVE
  To determine the effectiveness of a combined clomiphene citrate/gonadotropin protocol in a general infertility population and to evaluate factors influencing pregnancy rates obtained with this protocol.
  
  
  METHODS
  A retrospective chart review. SETTING; University-based infertility clinic.
  
  
  METHODS
  Two hundred forty-eight patients undergoing 658 cycles of minimal stimulation (MS) protocol from 1996-2000.
  
  
  METHODS
  Patients underwent treatment with clomiphene citrate and gonadotropin, often followed by intrauterine insemination.
  
  
  METHODS
  Clinical pregnancy rates.
  
  
  RESULTS
  Overall, the clinical pregnancy rate was 7.1% per cycle (n = 248 patients and 658 cycles). The age range of the patients was 24-47 years (mean +/- SD = 36.5 +/- 4.9) with 8.7% noted to have ovulatory dysfunction. Pregnancy rates varied significantly (P<.05) with patient age (9.3% in women <40 years vs. 2.4% in women > or =40), duration of infertility (9.0% in women with < or =3 years of infertility vs. 2.2% in women with >3 years of infertility) and number of follicles produced during stimulation (9.1% in women with > or =3 follicles vs. 4.6% in women with <3 follicles).
  
  
  CONCLUSIONS
  The effectiveness of the MS protocol in a general infertility population with a predominantly ovulatory status is much less than that previously reported in a younger patient population with a significant rate of ovulatory dysfunction. This protocol does not appear to lead to pregnancy rates higher than that reported for clomiphene citrate/intrauterine insemination (IUI) cycles. The clinical pregnancy rates using a minimal stimulation protocol are particularly compromised in women over 40, those with a longer duration of infertility or those who produce few follicles during stimulation.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Washington School of Medicine, Seattle, Washington, USA.
authors.forename: Brenda S
authors.initials: BS
authors.lastname: Houmard
authors.forename: M Peter
authors.initials: MP
authors.lastname: Juang
authors.forename: Michael R
authors.initials: MR
authors.lastname: Soules
authors.forename: Victor Y
authors.initials: VY
authors.lastname: Fujimoto
mesh_terms: D000328:Adult; D000367:Age Factors; D006063:Chorionic Gonadotropin / Q000494:pharmacology*; D002996:Clomiphene / Q000494:pharmacology*; D005260:Female; D005300:Fertility Agents, Female / Q000494:pharmacology*; D005640:Follicle Stimulating Hormone / Q000494:pharmacology*; D006801:Humans; D007315:Insemination, Artificial; D008297:Male; D008875:Middle Aged; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies
chemical_list: D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D002996:Clomiphene; D005640:Follicle Stimulating Hormone