Role of rescue IVF-ET treatment in the management of high response in stimulated IUI cycles.
Rescue in-vitro fertilisation and embryo transfer (IVF-ET) has been used in high response gonadotrophin intrauterine insemination (IUI) cycles to minimise the risks of ovarian hyperstimulation and multiple gestation. Such unplanned IVF treatment increases the cost of treatment. But can this added cost and the risks associated with IVF be justified? We present our experience with this treatment using clinical pregnancy and live birth rates as the primary outcomes. Between 1998 to 2001, 40 women undergoing IUI cycles who over responded (>3 follicles measuring >15 mm in diameter on the planned day of hCG administration) to gonadotrophin were offered the choice of conversion to IVF-ET or cancel the cycle. 17/40 declined rescue IVF/ET and had their cycles cancelled. 23/40 converted to IVF/ET and underwent transvaginal oocyte retrieval. 21/23 had embryo transferred. The clinical pregnancy and live birth rates were 52% and 48%, respectively. Rescue IVF-ET offers excellent clinical pregnancy and live birth rates in high responders. However, affordability can be an obstacle in the utilization of this treatment option.
Olufowobi
O
O
The Assisted Conception Unit, Birmingham Women's Hospital, Metchley Park Road, Birmingham B15 2TG, UK. follie@docfm.freeserve.co.uk
Sharif
K
K
Papaioannou
S
S
Mohamed
H
H
Neelakantan
D
D
Afnan
M
M
D000328:Adult; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D004624:Embryo Transfer / Q000191:economics* / Q000706:statistics & numerical data; D004739:England / Q000453:epidemiology; D005260:Female; D005307:Fertilization in Vitro / Q000191:economics* / Q000706:statistics & numerical data; D006062:Gonadotropins / Q000008:administration & dosage; D006801:Humans; D007231:Infant, Newborn; D008499:Medical Records; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013222:State Medicine; D006113:United Kingdom
D006062:Gonadotropins