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Oral ovulation induction agents combined with low-dose gonadotropin injections and intrauterine insemination: cost- and clinical effectiveness.
J Reprod Med. 2005 Dec; 50(12):943-50.JR

Abstract

OBJECTIVE

To compare the efficacy and cost-effectiveness of different induction protocols involving gonadotropins with intrauterine insemination (IUI).

STUDY DESIGN

We performed a retrospective chart review of 648 IUI cycles. Some patients had gonadotropin injections alone before human chorionic gonadotropin (hCG) and IUI (human menopausal gonadotropin protocol); others were given oral medications, then gonadotropins before hCG and IUI (combination protocol). Outcomes included pregnancy rates, multiple birth rates, endometrial thickness, number of ovarian follicles, injection days, ampules of gonadotropins and cost.

RESULTS

The combination protocol was more cost-effective. In first cycles, pregnancy rates, multiple birth rates, number of large follicles produced and cancellation rates were similar. The combination group had fewer days of injections and fewer ampules used. When all cycles were analyzed, the multiple birth rate was lower in the combination group. Comparing the different oral medications in the combination protocols, letrozole yielded higher pregnancy rates than tamoxifen or clomiphene. Multiple birth rates were similar for all oral medications.

CONCLUSION

Combination protocols are less costly and equally effective, with potentially fewer multiple births than with gonadotropins alone. Letrozole may be more effective than clomiphene and tamoxifen in a combination protocol.

Authors+Show Affiliations

Division of Reproductive Endocrinology and Infertility, University of Iowa Roy J. and Lucille A. Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City 52242, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16444896

Citation

Ryan, Ginny L., et al. "Oral Ovulation Induction Agents Combined With Low-dose Gonadotropin Injections and Intrauterine Insemination: Cost- and Clinical Effectiveness." The Journal of Reproductive Medicine, vol. 50, no. 12, 2005, pp. 943-50.
Ryan GL, Moss V, Davis WA, et al. Oral ovulation induction agents combined with low-dose gonadotropin injections and intrauterine insemination: cost- and clinical effectiveness. J Reprod Med. 2005;50(12):943-50.
Ryan, G. L., Moss, V., Davis, W. A., Sparks, A. E., Dokras, A., & Van Voorhis, B. J. (2005). Oral ovulation induction agents combined with low-dose gonadotropin injections and intrauterine insemination: cost- and clinical effectiveness. The Journal of Reproductive Medicine, 50(12), 943-50.
Ryan GL, et al. Oral Ovulation Induction Agents Combined With Low-dose Gonadotropin Injections and Intrauterine Insemination: Cost- and Clinical Effectiveness. J Reprod Med. 2005;50(12):943-50. PubMed PMID: 16444896.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Oral ovulation induction agents combined with low-dose gonadotropin injections and intrauterine insemination: cost- and clinical effectiveness. AU - Ryan,Ginny L, AU - Moss,Victoria, AU - Davis,William A, AU - Sparks,Amy E T, AU - Dokras,Anuja, AU - Van Voorhis,Bradley J, PY - 2006/2/1/pubmed PY - 2007/3/30/medline PY - 2006/2/1/entrez SP - 943 EP - 50 JF - The Journal of reproductive medicine JO - J Reprod Med VL - 50 IS - 12 N2 - OBJECTIVE: To compare the efficacy and cost-effectiveness of different induction protocols involving gonadotropins with intrauterine insemination (IUI). STUDY DESIGN: We performed a retrospective chart review of 648 IUI cycles. Some patients had gonadotropin injections alone before human chorionic gonadotropin (hCG) and IUI (human menopausal gonadotropin protocol); others were given oral medications, then gonadotropins before hCG and IUI (combination protocol). Outcomes included pregnancy rates, multiple birth rates, endometrial thickness, number of ovarian follicles, injection days, ampules of gonadotropins and cost. RESULTS: The combination protocol was more cost-effective. In first cycles, pregnancy rates, multiple birth rates, number of large follicles produced and cancellation rates were similar. The combination group had fewer days of injections and fewer ampules used. When all cycles were analyzed, the multiple birth rate was lower in the combination group. Comparing the different oral medications in the combination protocols, letrozole yielded higher pregnancy rates than tamoxifen or clomiphene. Multiple birth rates were similar for all oral medications. CONCLUSION: Combination protocols are less costly and equally effective, with potentially fewer multiple births than with gonadotropins alone. Letrozole may be more effective than clomiphene and tamoxifen in a combination protocol. SN - 0024-7758 UR - https://www.unboundmedicine.com/medline/citation/16444896/Oral_ovulation_induction_agents_combined_with_low_dose_gonadotropin_injections_and_intrauterine_insemination:_cost__and_clinical_effectiveness_ DB - PRIME DP - Unbound Medicine ER -