Clomiphene citrate intrauterine insemination (IUI) before gonadotropin IUI affects the pregnancy rate and the rate of high-order multiple pregnancies.
OBJECTIVE
To determine if previous treatment with clomiphene citrate intrauterine insemination (CC-IUI) affects pregnancy and high-order multiple pregnancy (HOMP) rates in subsequent hMG-IUI or FSH-IUI cycles.


METHODS
Retrospective cohort study.


METHODS
Private infertility clinic.


METHODS
Five hundred fifty-one patients (age <38 years) without tubal factor infertility, treated with 918 cycles of hMG/FSH-IUI after one or more unsuccessful cycles of CC-IUI; 908 patients treated with 1459 cycles of hMG/FSH-IUI without prior CC-IUI.


METHODS
CC-IUI, hMG-IUI, FSH-IUI.


METHODS
Pregnancy rate per cycle, HOMP (three or more gestational sacs).


RESULTS
Pregnancy rates during the first three hMG-IUI or FSH-IUI cycles averaged 21.8 +/- 1.1% without previous CC-IUI, 19.6 +/- 1.3% after one to four cycles of CC-IUI, and 3.6 +/- 2.6% after >or= five previous CC-IUI cycles. The HOMP rates were 8.8% without previous CC-IUI, 7.5% after one, 5.7% after two and <2.6% (0 out of 38) after >or= three previous CC-IUI cycles.


CONCLUSIONS
Pregnancy rates in hMG/FSH-IUI cycles are significantly reduced after four unsuccessful CC-IUI cycles. High-order multiple pregnancies due to hMG/HMG-IUI are reduced following previous unsuccessful CC-IUI cycles.
Dickey
Richard P
RP
The Fertility Institute of New Orleans, New Orleans, Louisiana 70128, USA. info@fertilityinstitute.com
Taylor
Steven N
SN
Lu
Peter Y
PY
Sartor
Belinda M
BM
Pyrzak
Roman
R
D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D002996:Clomiphene / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use*; D006801:Humans; D007315:Insemination, Artificial / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data*; D019233:Retreatment; D012189:Retrospective Studies
D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D002996:Clomiphene; D005640:Follicle Stimulating Hormone