title: Recombinant FSH increases live birth rates as compared to clomiphene citrate in intrauterine insemination cycles in couples with subfertility: a prospective randomized study.
abstract: OBJECTIVE
  To compare the efficacy of intrauterine insemination (IUI) cycles undergoing ovarian hyperstimulation with recombinant FSH (rFSH) or clomiphene citrate (CC) in couples with unexplained and male subfertility.
  
  
  METHODS
  Two hundred and nineteen subfertile couples were enrolled in this randomized prospective study. Patients were randomly assigned to receive 75IU rFSH or 100mg CC for two cycles. Cycles with more than four dominant follicles and/or serum E2 levels higher than 1500pg/ml were cancelled. Primary outcomes were live birth rates per patient and per cycle, secondary outcomes were clinical and multiple pregnancy rates.
  
  
  RESULTS
  One hundred and nine women received rFSH and 110 received CC. Both cumulative clinical pregnancy and live birth rates per patient were significantly higher in gonadotropin group (43.1% and 37.6%) as compared to CC group (28.2% and 20%) (p<0.05 and p<0.01, respectively). Live birth rate per cycle were significantly higher in gonadotropin group (24.3%) in comparison with CC group (13.8%) (p<0.05). However, clinical pregnancy rate per cycle was not different between groups (28.4% vs 20%) (p>0.05). There was no significant difference between gonadotropin and CC group groups in terms of multiple pregnancy rates (10.4% vs 12.5%, p>0.05). Continuous variables were compared with Student's t test. Categorical variables were compared with Chi square test.
  
  
  CONCLUSIONS
  rFSH has significantly higher cumulative clinical pregnancy and live birth rates when compared to CC with similar multiple pregnancy rates in subfertile patients undergoing IUI.
authors: Department of Obstetrics & Gynecology, Gazi University Faculty of Medicine, Ankara, Turkey.
authors: Mehmet
authors: M
authors: Erdem
authors: Department of Obstetrics & Gynecology, Gazi University Faculty of Medicine, Ankara, Turkey.
authors: Seraf
authors: S
authors: Abay
authors: Department of Obstetrics & Gynecology, Gazi University Faculty of Medicine, Ankara, Turkey.
authors: Ahmet
authors: A
authors: Erdem
authors: Department of Obstetrics & Gynecology, HRS Women Hospital, Ankara, Turkey. Electronic address: firatmutlu78@hotmail.com.
authors: Mehmet
authors: M
authors: Firat Mutlu
authors: Department of Obstetrics & Gynecology, Gazi University Faculty of Medicine, Ankara, Turkey.
authors: Esra
authors: E
authors: Nas
authors: IVF Unit, Novaart IVF and Women Health Center, Ankara, Turkey.
authors: Ilknur
authors: I
authors: Mutlu
authors: Department of Obstetrics & Gynecology, Gazi University Faculty of Medicine, Ankara, Turkey.
authors: Mesut
authors: M
authors: Oktem
mesh_terms: D000328:Adult; D002996:Clomiphene / Q000008:administration & dosage*; D005260:Female; D005300:Fertility Agents, Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D006801:Humans; D007246:Infertility / Q000628:therapy*; D007248:Infertility, Male / Q000628:therapy; D007315:Insemination, Artificial / Q000379:methods*; D007317:Insemination, Artificial, Homologous / Q000379:methods; D008297:Male; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D005300:Fertility Agents, Female; D011994:Recombinant Proteins; D002996:Clomiphene; D005640:Follicle Stimulating Hormone
keywords: Clomiphene citrate; Intrauterine insemination; Recombinant FSH