Assessing the risk of multiple gestation in gonadotropin intrauterine insemination cycles.
OBJECTIVE
The purpose of this study was to analyze factors for their ability to predict multiple gestation in women who undergo controlled ovarian hyperstimulation with gonadotropins (follicle-stimulating hormone/human menopausal gonadotropin) and intrauterine insemination.


METHODS
This was a retrospective analysis of the clinical and laboratory variables that are associated with multiple gestation. Data for 6 variables in 678 cycles of gonadotropin/intrauterine insemination between 1990 and 1999 were analyzed with survival analysis, Cox regression analysis, and multiple logistic regression.


RESULTS
There were 99 clinical pregnancies among 678 cycles (14.6% per cycle) in 306 women. Of the 14 women with multiple gestations (14.1% of pregnancies), 11 women had twins, 2 women had triplets, and 1 woman had quadruplets. Age, days of gonadotropin treatment, total dose of gonadotropin, and number of follicles that were >or=15 mm at the time of human chorionic gonadotropin administration were statistically significant predictors of multiple gestation in >or=1 of the statistical models.


CONCLUSIONS
The risk of multiple gestation with controlled ovarian hyperstimulation/intrauterine insemination in this study was relatively low. In addition to age, several controllable variables that are associated with multiple gestation were identified.
Kaplan
Paul F
PF
Fertility Center at Women's Care, Eugene, Ore., USA.
Patel
Misha
M
Austin
Douglas J
DJ
Freund
Richard
R
D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D005260:Female; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use*; D005544:Forecasting; D006801:Humans; D007317:Insemination, Artificial, Homologous; D008596:Menotropins / Q000627:therapeutic use*; D006080:Ovarian Follicle / Q000502:physiology; D011247:Pregnancy; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple; D011336:Probability; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis
D006063:Chorionic Gonadotropin; D008596:Menotropins; D005640:Follicle Stimulating Hormone