Prediction of chances for success or complications in gonadotrophin ovulation induction in normogonadotrophic anovulatory infertility.
This follow-up study evaluated whether initial screening characteristics predict treatment outcome of gonadotrophin induction of ovulation. One hundred and fifty-four women with normogonadotrophic anovulatory infertility for whom clomiphene citrate induction of ovulation was unsuccessful were included in the present study. Daily FSH injections were initiated on day 3-5 after spontaneous or progestagen-induced withdrawal bleeding. In most patients, a dose finding low-dose step-up regimen was applied during the first treatment cycle in order to identify the individual FSH response dose. In all subsequent cycles, a step-down protocol was applied. Initial serum concentrations of LH, testosterone and androstenedione were significant predictors for the probability of multi-follicular development. FSH treatment resulted in a total of 67 (44%) ongoing pregnancies. Comparing those women who did, versus those who did not, achieve an ongoing pregnancy in a multivariate Cox regression analysis, initial serum insulin-like growth factor-I (IGF-I), testosterone and women's age entered into the final model (AUC = 0.67). The individual treatment outcome following gonadotrophin induction of ovulation may be predicted by initial screening characteristics.
Department of Obstetrics and Gynecology, Erasmus Medical Centre, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
Annemarie G M G J
AG
Mulders
Marinus J C
MJ
Eijkemans
Babak
B
Imani
Bart C J M
BC
Fauser
D000328:Adult; D000735:Androstenedione / Q000097:blood; D000858:Anovulation / Q000188:drug therapy*; D015992:Body Mass Index; D005260:Female; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy*; D008137:Longitudinal Studies; D007986:Luteinizing Hormone / Q000097:blood; D015999:Multivariate Analysis; D010062:Ovulation Induction / Q000009:adverse effects* / Q000706:statistics & numerical data; D011085:Polycystic Ovary Syndrome / Q000150:complications; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D013739:Testosterone / Q000097:blood
D013739:Testosterone; D000735:Androstenedione; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone