title: Clomiphene citrate intrauterine insemination (IUI) before gonadotropin IUI affects the pregnancy rate and the rate of high-order multiple pregnancies.
abstract: 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.
authors.affiliation: The Fertility Institute of New Orleans, New Orleans, Louisiana 70128, USA. info@fertilityinstitute.com
authors.forename: Richard P
authors.initials: RP
authors.lastname: Dickey
authors.forename: Steven N
authors.initials: SN
authors.lastname: Taylor
authors.forename: Peter Y
authors.initials: PY
authors.lastname: Lu
authors.forename: Belinda M
authors.initials: BM
authors.lastname: Sartor
authors.forename: Roman
authors.initials: R
authors.lastname: Pyrzak
mesh_terms: 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
chemical_list: D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D002996:Clomiphene; D005640:Follicle Stimulating Hormone