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What is the optimal follicular size before triggering ovulation in intrauterine insemination cycles with clomiphene citrate or letrozole? An analysis of 988 cycles.
Fertil Steril. 2012 May; 97(5):1089-94.e1-3.FS

Abstract

OBJECTIVE

To determine the optimal size of the leading follicle before human chorionic gonadotropin (hCG) administration in cycles with clomiphene citrate (CC) and letrozole, and to examine any differences in the optimal leading follicle size between cycles with CC and letrozole.

DESIGN

A retrospective study.

SETTING

University hospital-based reproductive center.

PATIENT(S)

1,075 women undergoing intrauterine insemination cycles with CC or letrozole.

INTERVENTION(S)

Leading follicle diameters and endometrial thickness were recorded 24 hours before hCG administration, together with other cycles parameters, and were compared between pregnant and nonpregnant patients.

MAIN OUTCOME MEASURE(S)

Leading follicle diameter and intrauterine insemination outcome.

RESULT(S)

Eight percent of patients (n = 87) were excluded because their leading follicle was less than 18 mm by days 11 to 13. Pregnancy was recorded as clinical pregnancy with fetal heart activity seen at 6- to 7-week transvaginal ultrasound. For both CC and letrozole, higher pregnancy rates were achieved when the leading follicles were in the 23 to 28 mm range. The optimal size of the leading follicle was not statistically significantly different between cycles using CC or letrozole. However, for each endometrial thickness, the optimal follicular size of the leading follicle was different. Each additional millimeter of endometrial thickness increased the optimal follicular size by 0.5 mm. Thicker endometrial lining led to a higher probability of pregnancy.

CONCLUSION(S)

The optimal size of the leading follicle in ovulation induction with CC and letrozole is similar for both drugs and is closely related to the endometrial thickness.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Froedtert Hospital, Medical College of Wisconsin Affiliated Hospitals, Milwaukee, Wisconsin 53226, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

22459633

Citation

Palatnik, Anna, et al. "What Is the Optimal Follicular Size Before Triggering Ovulation in Intrauterine Insemination Cycles With Clomiphene Citrate or Letrozole? an Analysis of 988 Cycles." Fertility and Sterility, vol. 97, no. 5, 2012, pp. 1089-94.e1-3.
Palatnik A, Strawn E, Szabo A, et al. What is the optimal follicular size before triggering ovulation in intrauterine insemination cycles with clomiphene citrate or letrozole? An analysis of 988 cycles. Fertil Steril. 2012;97(5):1089-94.e1-3.
Palatnik, A., Strawn, E., Szabo, A., & Robb, P. (2012). What is the optimal follicular size before triggering ovulation in intrauterine insemination cycles with clomiphene citrate or letrozole? An analysis of 988 cycles. Fertility and Sterility, 97(5), 1089-e1-3. https://doi.org/10.1016/j.fertnstert.2012.02.018
Palatnik A, et al. What Is the Optimal Follicular Size Before Triggering Ovulation in Intrauterine Insemination Cycles With Clomiphene Citrate or Letrozole? an Analysis of 988 Cycles. Fertil Steril. 2012;97(5):1089-94.e1-3. PubMed PMID: 22459633.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - What is the optimal follicular size before triggering ovulation in intrauterine insemination cycles with clomiphene citrate or letrozole? An analysis of 988 cycles. AU - Palatnik,Anna, AU - Strawn,Estil, AU - Szabo,Aniko, AU - Robb,Paul, Y1 - 2012/03/28/ PY - 2011/09/28/received PY - 2012/01/25/revised PY - 2012/02/14/accepted PY - 2012/3/31/entrez PY - 2012/3/31/pubmed PY - 2012/6/26/medline SP - 1089-94.e1-3 JF - Fertility and sterility JO - Fertil. Steril. VL - 97 IS - 5 N2 - OBJECTIVE: To determine the optimal size of the leading follicle before human chorionic gonadotropin (hCG) administration in cycles with clomiphene citrate (CC) and letrozole, and to examine any differences in the optimal leading follicle size between cycles with CC and letrozole. DESIGN: A retrospective study. SETTING: University hospital-based reproductive center. PATIENT(S): 1,075 women undergoing intrauterine insemination cycles with CC or letrozole. INTERVENTION(S): Leading follicle diameters and endometrial thickness were recorded 24 hours before hCG administration, together with other cycles parameters, and were compared between pregnant and nonpregnant patients. MAIN OUTCOME MEASURE(S): Leading follicle diameter and intrauterine insemination outcome. RESULT(S): Eight percent of patients (n = 87) were excluded because their leading follicle was less than 18 mm by days 11 to 13. Pregnancy was recorded as clinical pregnancy with fetal heart activity seen at 6- to 7-week transvaginal ultrasound. For both CC and letrozole, higher pregnancy rates were achieved when the leading follicles were in the 23 to 28 mm range. The optimal size of the leading follicle was not statistically significantly different between cycles using CC or letrozole. However, for each endometrial thickness, the optimal follicular size of the leading follicle was different. Each additional millimeter of endometrial thickness increased the optimal follicular size by 0.5 mm. Thicker endometrial lining led to a higher probability of pregnancy. CONCLUSION(S): The optimal size of the leading follicle in ovulation induction with CC and letrozole is similar for both drugs and is closely related to the endometrial thickness. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/22459633/What_is_the_optimal_follicular_size_before_triggering_ovulation_in_intrauterine_insemination_cycles_with_clomiphene_citrate_or_letrozole_An_analysis_of_988_cycles_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(12)00250-6 DB - PRIME DP - Unbound Medicine ER -