Follicular response and pregnancy among infertile women undergoing ovulation induction and intrauterine insemination.
OBJECTIVE
To determine the relationship between ovarian follicular response (number and diameter of follicles) to ovulation induction agents and pregnancy.


METHODS
Retrospective cohort study.Hospital-based center of reproductive medicine.


METHODS
Three hundred twenty-two clinically diagnosed infertile couples undergoing 1483 cycles of ovulation induction and IUI. Oral and injectable fertility drugs were administered for 2-10 cycles; ultrasound follicular measurements were recorded around time of ovulation; hCG was administered when follicles were 18-20 mm or more in diameter; IUI was performed 36-40 hours after administration of hCG.


METHODS
A first positive pregnancy test as indicative for conception. Women with follicular diameters >or=20 mm were less likely to become pregnant as compared to women with diameters between 15.00 and 19.99 mm (risk ratio [RR] = 0.58, 95% confidence interval [CI] = 0.35, 0.97). Women >or=30 years of age were half as likely to become pregnant as compared to women <30 years (RR = 0.51, 95% CI = 0.30, 0.85). Likelihood of pregnancy increased by 21% for each prior pregnancy (RR = 1.21, 95% CI = 1.00, 1.47).


CONCLUSIONS
Maternal age, gravidity, and follicular diameters around the time of insemination are prognostic factors in the likelihood of pregnancy.
Ghosh
Chaitali
C
Department of Social and Preventive Medicine, University at Buffalo, Buffalo, New York 14222, USA.
Buck
Germaine
G
Priore
Roger
R
Wacktawski-Wende
Jean
J
Severino
Mark
M
D015331:Cohort Studies; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D007317:Insemination, Artificial, Homologous; D016013:Likelihood Functions; D008423:Maternal Age; D015999:Multivariate Analysis; D016017:Odds Ratio; D006080:Ovarian Follicle; D010062:Ovulation Induction; D010298:Parity; D011247:Pregnancy; D018873:Pregnancy Rate; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D014463:Ultrasonography