title: Association of the number of follicles of various sizes and treatment protocol with multiple pregnancies following ovulation induction and intrauterine insemination.
abstract: OBJECTIVE
  To find the relationship between the number of follicles of different sizes and the stimulation protocol to the probability of multiple pregnancies.
  
  
  METHODS
  Out of 2034 cycles of OI-IUI in a university based infertility center, between March 2003 to March 2006, there were 322 clinically pregnant cycles. The following variables were tabulated for each cycle: female age, treatment protocol, follicle number and size on the day of hCG administration and number of gestational sacs detected by transvaginal ultrasonography at 9 weeks of gestation. Ovulation induction was done by cc, cc+hMG or hMG. Follicles were categorized by size as = 18mm, = 15mm and = 12mm. To find the relationship between singleton and multiple pregnancy with the average number of follicles of different sizes and the protocol of treatment, a statistical analysis was performed.
  
  
  RESULTS
  There were 38 (11.8%) multiple pregnancies in 322 pregnant cycles. consisting of 26 (8.1%) twin, 11 (3.4%) triplet and 1 (0.3%) quintuplet. Multiple pregnancy rate in cc, cc+hMG and hMG cycles were 9.01%, 12.2% and 15% respectively. There was no significant relationship between different treatment protocols and the risk of multiple pregnancy (p > 0.1). The number of follicles > or = 12 mm or > or = 15 mm or > or = 18 mm had significant relationship with single and multiple pregnancies (p < 0.01), but the correlation coefficient was higher for > or = 18 mm follicles. The mean age of the singleton and multiple pregnant women was not significantly different (p > 0.1).
  
  
  CONCLUSIONS
  The risk of multiple conceptions is related to > or = 18 mm follicles in addition to the total number of follicles >12 mm. Different protocol of ovulation induction revealed no relationship with the risk of multiple conceptions.
authors.affiliation: Montaserieh IVF Center, Mashhad University of Medical Sciences, Iran.
authors.forename: Nezhat
authors.initials: N
authors.lastname: Moosavifar
authors.forename: Masoomeh
authors.initials: M
authors.lastname: Aliakbarzadeh
authors.forename: Mohammadtaghi
authors.initials: M
authors.lastname: Shakeri
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007246:Infertility; D007315:Insemination, Artificial; D008297:Male; D006080:Ovarian Follicle; D010062:Ovulation Induction; D010298:Parity; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D006063:Chorionic Gonadotropin