Factors influencing pregnancy rates with a combined clomiphene citrate/gonadotropin protocol for non-assisted reproductive technology fertility treatment

Brenda S. Houmard, M Peter Juang, Michael R. Soules, Victor Y. Fujimoto
Fertility and sterility · 2002 · vol. 77(2) , pp. 384–386 · doi:10.1016/s0015-0282(01)02990-9 · PMID:11821101 · W2014187982
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This study investigated factors affecting pregnancy rates in non-ART fertility treatments using a combined clomiphene citrate and gonadotropin protocol.

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Abstract

OBJECTIVE: To determine the effectiveness of a combined clomiphene citrate/gonadotropin protocol in a general infertility population and to evaluate factors influencing pregnancy rates obtained with this protocol. DESIGN: A retrospective chart review. SETTING; University-based infertility clinic. PATIENT(S): Two hundred forty-eight patients undergoing 658 cycles of minimal stimulation (MS) protocol from 1996-2000. INTERVENTION(S): Patients underwent treatment with clomiphene citrate and gonadotropin, often followed by intrauterine insemination. MAIN OUTCOME MEASURE(S): Clinical pregnancy rates. RESULT(S): Overall, the clinical pregnancy rate was 7.1% per cycle (n = 248 patients and 658 cycles). The age range of the patients was 24-47 years (mean +/- SD = 36.5 +/- 4.9) with 8.7% noted to have ovulatory dysfunction. Pregnancy rates varied significantly (P<.05) with patient age (9.3% in women or =40), duration of infertility (9.0% in women with 3 years of infertility) and number of follicles produced during stimulation (9.1% in women with > or =3 follicles vs. 4.6% in women with <3 follicles). CONCLUSION(S): The effectiveness of the MS protocol in a general infertility population with a predominantly ovulatory status is much less than that previously reported in a younger patient population with a significant rate of ovulatory dysfunction. This protocol does not appear to lead to pregnancy rates higher than that reported for clomiphene citrate/intrauterine insemination (IUI) cycles. The clinical pregnancy rates using a minimal stimulation protocol are particularly compromised in women over 40, those with a longer duration of infertility or those who produce few follicles during stimulation.

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MeSH descriptors

Chorionic Gonadotropin Clomiphene Fertility Agents, Female Follicle Stimulating Hormone Ovulation Induction Adult Age Factors Chorionic Gonadotropin Clomiphene Female Fertility Agents, Female Follicle Stimulating Hormone Humans Insemination, Artificial Male Middle Aged Ovulation Induction Pregnancy Pregnancy Rate Retrospective Studies

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