title: Recombinant FSH versus clomiphene citrate for ovarian stimulation in couples with unexplained infertility and male subfertility undergoing intrauterine insemination: a randomized trial.
abstract: OBJECTIVE
  To compare the efficacy of clomiphene citrate (CC) and recombinant FSH (rFSH) protocols in ovarian stimulation (OS)/intrauterine insemination (IUI) cycles for couples with unexplained infertility or male subfertility.
  
  
  METHODS
  One hundred and eighty-nine patients with unexplained or male subfertility were randomized to treatment with 100 mg/day CC for 5 days (93 patients) or rFSH with starting dose of 75-100 IU daily (96 patients). The main outcome measurement was ongoing pregnancy rate (OPR).
  
  
  RESULTS
  The number of preovulatory (≥ 17 mm) follicles on the day of hCG administration was significantly greater in the rFSH group than in the CC group (1.7 vs. 1.4, P = .01). Multifollicular growth was observed in 35.1% in the CC group and 54.8% in the FSH group (P = .01). The OPR per cycle was 9.6 and 15.6% for CC and rFSH groups, respectively (P = .31).
  
  
  CONCLUSIONS
  Recombinant FSH is superior to CC for enabling multifollicular development in OS/IUI cycles of unexplained and male subfertile couples. Although this finding did not lead to a statistically significant superiority of rFSH in terms of clinical outcomes, the presence of relative increase by 62.5% in OPR with rFSH may be regarded as a clinically significant trend.
authors.affiliation: Department of Obstetrics and Gynecology, Ankara University School of Medicine, Ankara, Turkey. bulentberker@gmail.com
authors.forename: Bulent
authors.initials: B
authors.lastname: Berker
authors.forename: Korhan
authors.initials: K
authors.lastname: Kahraman
authors.forename: Salih
authors.initials: S
authors.lastname: Taskin
authors.forename: Yavuz Emre
authors.initials: YE
authors.lastname: Sukur
authors.forename: Murat
authors.initials: M
authors.lastname: Sonmezer
authors.forename: Cem Somer
authors.initials: CS
authors.lastname: Atabekoglu
mesh_terms: D000328:Adult; D002996:Clomiphene / Q000008:administration & dosage*; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D006801:Humans; D007246:Infertility / Q000188:drug therapy*; D007315:Insemination, Artificial; D008297:Male; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D011994:Recombinant Proteins / Q000008:administration & dosage; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005300:Fertility Agents, Female; D011994:Recombinant Proteins; D002996:Clomiphene; D005640:Follicle Stimulating Hormone