title: Low dose recombinant FSH treatment may reduce multiple gestations caused by controlled ovarian hyperstimulation and intrauterine insemination.
abstract: OBJECTIVE
  To evaluate the rate of multiple pregnancies in intrauterine insemination cycles stimulated with a minimal dose of recombinant follicle stimulating hormone (rec-FSH).
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  University Medical Center.
  
  
  METHODS
  A total of 1256 patients underwent 3219 consequent intrauterine insemination cycles with minimal ovarian stimulation.
  
  
  METHODS
  Patients received 50 or 75 IU of rec-FSH from day four to day seven. The dose was adjusted according to oestradiol (E(2)) levels in order to achieve a maximum of two follicles on the day of hCG administration.
  
  
  METHODS
  Peak E(2) levels, the number of follicles >15 mm and pregnancy rates were calculated. The predictive value of E(2) levels for multiple gestations was also estimated.
  
  
  RESULTS
  Of 3219 cycles, 334 resulted in pregnancies (10%). Of these, 238 (91%) were singletons, 28 (8%) twins and 1 (0.3%) was a triplet. The cumulative overall pregnancy rate was 43%. Patients over 40 years old had a significantly lower pregnancy rate per cycle and overall live birth rate (P < 0.05). Most pregnancies (83%) occurred during the first three cycles. Pregnancy rates per cycle varied from 8% for tubal factor to 14% for anovulation infertility.
  
  
  CONCLUSIONS
  Minimal FSH stimulation in intrauterine insemination cycles may reduce the rates of twins and high order multiple pregnancies without affecting overall pregnancy rates.
authors.affiliation: Service Gynécologie-Obstétrique III, Clinique Universitaire Baudelocque, Hôpital Cochin, Paris, France.
authors.forename: Theocharis C
authors.initials: TC
authors.lastname: Papageorgiou
authors.forename: Juliette
authors.initials: J
authors.lastname: Guibert
authors.forename: Michèle
authors.initials: M
authors.lastname: Savale
authors.forename: François
authors.initials: F
authors.lastname: Goffinet
authors.forename: Charles
authors.initials: C
authors.lastname: Fournier
authors.forename: Françoise
authors.initials: F
authors.lastname: Merlet
authors.forename: Yvette
authors.initials: Y
authors.lastname: Janssens
authors.forename: Jean-René
authors.initials: JR
authors.lastname: Zorn
mesh_terms: D000328:Adult; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy*; D007317:Insemination, Artificial, Homologous / Q000379:methods*; D010062:Ovulation Induction / Q000009:adverse effects*; D011247:Pregnancy; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple; D011446:Prospective Studies; D012372:ROC Curve; D011994:Recombinant Proteins; D012189:Retrospective Studies
chemical_list: D011994:Recombinant Proteins; D005640:Follicle Stimulating Hormone