title: Comparison of stimulation with clomiphene citrate in combination with recombinant follicle-stimulating hormone and recombinant luteinizing hormone to stimulation with a gonadotropin-releasing hormone agonist protocol: a prospective, randomized study.
abstract: OBJECTIVE
  To compare IVF-ET outcome with a new stimulation protocol using clomiphene citrate (CC) with recombinant FSH and LH to stimulation with the standard long GnRH-a protocol.
  
  
  METHODS
  Prospective randomized study.
  
  
  METHODS
  Outpatient infertility clinic in Vienna, Austria.
  
  
  METHODS
  Two hundred ninety-four infertile women undergoing IVF-ET; 154 IVF cycles stimulated with CC + recombinant FSH + recombinant LH (group A) and 140 cycles with long GnRH-a suppression + recombinant FSH (group B).
  
  
  METHODS
  Controlled ovarian hyperstimulation, egg retrieval, and ET.
  
  
  METHODS
  Cycle parameters (number of oocytes, fertilization, number of embryos) and outcome (pregnancy rate, cancellation rate, ovarian hyperstimulation syndrome [OHSS]).
  
  
  RESULTS
  Pregnancy rate per ET was 42.9% (implantation rate, 21.3%) in group A and 36.6% (17.4%) in group B. Cancellation rates were similar. The OHSS occurred in four cases (3%) in group A and 12 cases (10%) in group B.
  
  
  CONCLUSIONS
  Stimulation with CC + recombinant FSH + recombinant LH leads to comparable pregnancy rates vs. the long protocol. With this new stimulation, less gonadotropins are used and there is less need for monitoring (lower cost for patient and clinic). The risk of OHSS is reduced as well. Therefore, this protocol should be regarded as the first-line treatment.
authors.affiliation: Institut für Sterilitätsbetreuung, Vienna, Austria
authors.forename: Monika
authors.initials: M
authors.lastname: Weigert
authors.forename: Ursula
authors.initials: U
authors.lastname: Krischker
authors.forename: Michaela
authors.initials: M
authors.lastname: Pöhl
authors.forename: Gunda
authors.initials: G
authors.lastname: Poschalko
authors.forename: Christoph
authors.initials: C
authors.lastname: Kindermann
authors.forename: Wilfried
authors.initials: W
authors.lastname: Feichtinger
mesh_terms: D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004624:Embryo Transfer; D005260:Female; D005300:Fertility Agents, Female; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D007986:Luteinizing Hormone / Q000627:therapeutic use*; D008297:Male; D009865:Oocytes; D016471:Ovarian Hyperstimulation Syndrome / Q000453:epidemiology / Q000209:etiology; D010062:Ovulation Induction / Q000009:adverse effects / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D020858:Tissue and Organ Harvesting
chemical_list: D005300:Fertility Agents, Female; D006728:Hormones; D011994:Recombinant Proteins; D002996:Clomiphene; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone