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.
Mulders
Annemarie G M G J
AG
Department of Obstetrics and Gynecology, Erasmus Medical Centre, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
Eijkemans
Marinus J C
MJ
Imani
Babak
B
Fauser
Bart C J M
BC
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