Low dose recombinant FSH treatment may reduce multiple gestations caused by controlled ovarian hyperstimulation and intrauterine insemination.
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.
Papageorgiou
Theocharis C
TC
Service Gynécologie-Obstétrique III, Clinique Universitaire Baudelocque, Hôpital Cochin, Paris, France.
Guibert
Juliette
J
Savale
Michèle
M
Goffinet
François
F
Fournier
Charles
C
Merlet
Françoise
F
Janssens
Yvette
Y
Zorn
Jean-René
JR
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
D011994:Recombinant Proteins; D005640:Follicle Stimulating Hormone