A randomized study comparing IVF in the unstimulated cycle with IVF following clomiphene citrate

被引:47
作者
Ingerslev, HJ [1 ]
Hojgaard, A
Hindkjær, J
Kesmodel, U
机构
[1] Aarhus Univ Hosp, Skejby Sygehus, Fertil Clin, DK-8200 Aarhus N, Denmark
[2] Aarhus Univ Hosp, Skejby Sygehus, Dept Obstet & Gynaecol, Perinatal Epidemiol Res Unit, DK-8200 Aarhus, Denmark
关键词
clinical pregnancy rate; clomiphene citraten; IVF; unstimulated cycles;
D O I
10.1093/humrep/16.4.696
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
The efficiency of IVF in unstimulated cycles was compared with that following ovarian stimulation with clomiphene citrate in a simple protocol with ultrasound monitoring only. A total of 132 couples with no previous IVF attempts, selected by female age <35 years, indication for intracytoplasmic sperm injection or infertility caused by tubal factor or unexplained infertility were randomized to the two protocols. Randomization yielded two comparable groups. The clomiphene group (68 couples) performed significantly better than the unstimulated group (64 couples) in terms of number of cycles with oocyte harvest (90/111 or 81% versus 65/114 or 57%; <chi>(2) = 9.21, P < 0.002), embryo transfers per started cycle (59/111 or 53% versus 29/114 or 25%; <chi>(2) = 18.14, P < 0.0001), live intrauterine pregnancy rate per started cycle (20/111 or 18% versus 4/114 or 4%; <chi>(2) = 12.42, P < 0.0001), live intrauterine pregnancy rate per embryo transfer (20/59 or 34% versus 4/29 or 14%; <chi>(2) = 3.96, P = 0.047), but not in terms of implantation rate (22/85 or 26% versus 4/29 or 14%; chi (2) = 1.65). Only two twin pregnancies occurred. Modest side-effects were recorded following clomiphene, Accordingly, a simple clomiphene citrate protocol, but not IVF in unstimulated cycles, seems compatible with the concept of 'friendly IVF', yielding a fair pregnancy rate both per cycle started and per embryo transfer in selected patients. The results do not substantiate any important negative anti-oestrogenic effects of clomiphene.
引用
收藏
页码:696 / 702
页数:7
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