Clomiphene citrate monitoring for intrauterine insemination timing: a randomized trial.
OBJECTIVE
To compare pregnancy rates with two different methods of intrauterine insemination (IUI) timing in patients treated with clomiphene citrate (CC).


METHODS
Prospective, randomized trial.


METHODS
Academic medical center.


METHODS
One hundred fifty ovulatory, infertile women.


METHODS
Patients were randomized into a luteinizing hormone (LH) surge group or a follicle monitoring/human chorionic gonadotropin (hCG) group. All patients underwent baseline ultrasound, and took clomiphene citrate, during days 5-9. Patients in the LH surge group underwent IUI on the day after a home test for the LH surge was positive, whereas those in the hCG group received hCG according to ultrasound parameters and underwent insemination 33-40 hours later. Patients remained in the same study group for up to three cycles.


METHODS
Pregnancy rates per cycle and per patient.


RESULTS
No significant differences were found between groups in pregnancy rates per patient or per cycle. The LH surge group underwent IUI significantly later than the hCG group. Cancellation rates were significantly higher for the LH surge group (31% vs. 11%) and attributable mainly to failure to detect an LH surge. The majority of pregnancies in both treatment groups occurred in the first cycle.


CONCLUSIONS
The decision to use hCG for IUI timing should be influenced by factors other than pregnancy rates.
Lewis
Vivian
V
Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, USA. vivian_lewis@urmc.rochester.edu
Queenan
John
J
Hoeger
Kathleen
K
Stevens
Joanne
J
Guzick
David S
DS
D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood*; D002996:Clomiphene / Q000627:therapeutic use*; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy*; D007317:Insemination, Artificial, Homologous; D007986:Luteinizing Hormone / Q000097:blood*; D008297:Male; D006080:Ovarian Follicle / Q000000981:diagnostic imaging*; D011247:Pregnancy; D018873:Pregnancy Rate; D013997:Time Factors; D014463:Ultrasonography
D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D002996:Clomiphene; D007986:Luteinizing Hormone