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Preventing high-order multiple pregnancies during controlled ovarian hyperstimulation and intrauterine insemination: 3 years' experience using low-dose recombinant follicle-stimulating hormone and gonadotropin-releasing hormone antagonists.
Fertil Steril 2006; 85(3):619-24FS

Abstract

OBJECTIVE

To employ protocols of mild ovarian stimulation to prevent an excessively elevated rate of high-order multiple pregnancies.

DESIGN

Case series.

SETTING

University hospital.

PATIENT(S)

Six hundred and twenty one consecutive patients undergoing 1,259 controlled ovarian hyperstimulation and intrauterine insemination cycles.

INTERVENTION(S)

Patients received 50 IU per day of recombinant follicle-stimulating hormone (FSH) starting the third day of the cycle, then a gonadotropin-releasing hormone (GnRH) antagonist on the day in which a follicle > or =13 mm was visualized. Cycles were canceled if three or more follicles > or =16 mm and/or five or more follicles > or =11 mm were detected.

MAIN OUTCOME MEASURE(S)

Rate of high-order multiple pregnancies.

RESULT(S)

The clinical pregnancy rate per initiated cycle was 9.2% (95% confidence interval, 7.5-11.1%). The incidence of twins and high-order multiple pregnancies was 9.5% (95% CI, 5.3-16.2%) and 0 (0.0-3.2%), respectively.

CONCLUSION(S)

In controlled ovarian hyperstimulation and intrauterine insemination cycles, a protocol of 50 IU of recombinant FSH daily combined with the use of GnRH antagonists and a policy of strict cancellation based on echographic criteria are associated with a satisfactory pregnancy rate per initiated cycle and a low risk of high-order multiple pregnancies.

Authors+Show Affiliations

Department of Obstetrics-Gynecology, Ospedale Maggiore Policlinico, Mangiagalli and Regina Elena, Italy.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

16500328

Citation

Ragni, Guido, et al. "Preventing High-order Multiple Pregnancies During Controlled Ovarian Hyperstimulation and Intrauterine Insemination: 3 Years' Experience Using Low-dose Recombinant Follicle-stimulating Hormone and Gonadotropin-releasing Hormone Antagonists." Fertility and Sterility, vol. 85, no. 3, 2006, pp. 619-24.
Ragni G, Caliari I, Nicolosi AE, et al. Preventing high-order multiple pregnancies during controlled ovarian hyperstimulation and intrauterine insemination: 3 years' experience using low-dose recombinant follicle-stimulating hormone and gonadotropin-releasing hormone antagonists. Fertil Steril. 2006;85(3):619-24.
Ragni, G., Caliari, I., Nicolosi, A. E., Arnoldi, M., Somigliana, E., & Crosignani, P. G. (2006). Preventing high-order multiple pregnancies during controlled ovarian hyperstimulation and intrauterine insemination: 3 years' experience using low-dose recombinant follicle-stimulating hormone and gonadotropin-releasing hormone antagonists. Fertility and Sterility, 85(3), pp. 619-24.
Ragni G, et al. Preventing High-order Multiple Pregnancies During Controlled Ovarian Hyperstimulation and Intrauterine Insemination: 3 Years' Experience Using Low-dose Recombinant Follicle-stimulating Hormone and Gonadotropin-releasing Hormone Antagonists. Fertil Steril. 2006;85(3):619-24. PubMed PMID: 16500328.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preventing high-order multiple pregnancies during controlled ovarian hyperstimulation and intrauterine insemination: 3 years' experience using low-dose recombinant follicle-stimulating hormone and gonadotropin-releasing hormone antagonists. AU - Ragni,Guido, AU - Caliari,Ilaria, AU - Nicolosi,Anna Elisa, AU - Arnoldi,Mariangela, AU - Somigliana,Edgardo, AU - Crosignani,Pier Giorgio, PY - 2005/05/18/received PY - 2005/09/06/revised PY - 2005/09/06/accepted PY - 2006/2/28/pubmed PY - 2006/3/22/medline PY - 2006/2/28/entrez SP - 619 EP - 24 JF - Fertility and sterility JO - Fertil. Steril. VL - 85 IS - 3 N2 - OBJECTIVE: To employ protocols of mild ovarian stimulation to prevent an excessively elevated rate of high-order multiple pregnancies. DESIGN: Case series. SETTING: University hospital. PATIENT(S): Six hundred and twenty one consecutive patients undergoing 1,259 controlled ovarian hyperstimulation and intrauterine insemination cycles. INTERVENTION(S): Patients received 50 IU per day of recombinant follicle-stimulating hormone (FSH) starting the third day of the cycle, then a gonadotropin-releasing hormone (GnRH) antagonist on the day in which a follicle > or =13 mm was visualized. Cycles were canceled if three or more follicles > or =16 mm and/or five or more follicles > or =11 mm were detected. MAIN OUTCOME MEASURE(S): Rate of high-order multiple pregnancies. RESULT(S): The clinical pregnancy rate per initiated cycle was 9.2% (95% confidence interval, 7.5-11.1%). The incidence of twins and high-order multiple pregnancies was 9.5% (95% CI, 5.3-16.2%) and 0 (0.0-3.2%), respectively. CONCLUSION(S): In controlled ovarian hyperstimulation and intrauterine insemination cycles, a protocol of 50 IU of recombinant FSH daily combined with the use of GnRH antagonists and a policy of strict cancellation based on echographic criteria are associated with a satisfactory pregnancy rate per initiated cycle and a low risk of high-order multiple pregnancies. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/16500328/Preventing_high_order_multiple_pregnancies_during_controlled_ovarian_hyperstimulation_and_intrauterine_insemination:_3_years'_experience_using_low_dose_recombinant_follicle_stimulating_hormone_and_gonadotropin_releasing_hormone_antagonists_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(05)04010-0 DB - PRIME DP - Unbound Medicine ER -