Assisted Reproduction Unit, Department of Obstetrics and Gynaecology, King Abdulaziz University, Soliman Fakeeh Hospital, Jeddah, Saudi Arabia.
J Multidiscip Healthc. 2011;4:119-24. doi: 10.2147/JMDH.S19569. Epub 2011 May 10.
There is a trend to cancel intrauterine insemination (IUI) in women with a high response. The aim of this study was to evaluate the efficacy of low-cost in vitro fertilization (IVF) in high-response IUI cycles in comparison with conventional IVF.
A total of 46 women were included in the study. Group A (study group) included 23 women with hyper-response to IUI cycles who were converted to IVF. They received oral letrozole 2.5 mg twice daily from days 3-7 of the menstrual cycle, along with 75 International Units (IU) of recombinant follicle-stimulating hormone on days 3 and 8. Group B (control group) underwent conventional IVF, and received downregulation with a gonadotrophin-releasing hormone agonist followed by stimulation with recombinant follicle-stimulating hormone 150-300 IU/day. Ovulation was triggered by 10,000 IU of human chorionic gonadotrophin, followed by IVF and embryo transfer. The primary outcome measure analyzed was pregnancy rates in both groups.
The study group received a significantly lower (P = 0.001) total dose of follicle-stimulating hormone and had significantly (P = 0.002) decreased levels of terminal estradiol. Although the pregnancy rate (30.43% in the study group versus 39.13% in the conventional group) per stimulated cycle was higher in the conventional IVF group, the miscarriage rate (study group 4.34% versus conventional group 13.04%) was also higher, and hence the take-home baby rate (study group 26.08% versus conventional group 30.43%) was more or less similar in both the groups.
IVF can be offered to women having a high response to IUI cycles with good pregnancy rates and at low cost compared with use of a conventional protocol, and therefore can be considered more patient-friendly in selected cases.
在高反应性的女性中，取消宫腔内人工授精（IUI）的趋势正在出现。本研究的目的是评估低成本体外受精（IVF）在高反应性 IUI 周期中的疗效，并与常规 IVF 进行比较。
共有 46 名女性纳入本研究。A 组（研究组）包括 23 名对 IUI 周期反应过度的女性，她们被转换为 IVF。她们在月经周期的第 3-7 天口服来曲唑 2.5mg，每日 2 次，同时在第 3 和 8 天给予 75 国际单位（IU）重组卵泡刺激素。B 组（对照组）接受常规 IVF，接受促性腺激素释放激素激动剂下调，然后用 150-300IU/天的重组卵泡刺激素进行刺激。通过 10000IU 人绒毛膜促性腺激素触发排卵，然后进行 IVF 和胚胎移植。主要观察指标是两组的妊娠率。
研究组接受的卵泡刺激素总剂量明显较低（P=0.001），终末雌二醇水平明显降低（P=0.002）。尽管研究组的妊娠率（30.43%）高于常规组（39.13%），但流产率（研究组 4.34%比常规组 13.04%）也较高，因此活产率（研究组 26.08%比常规组 30.43%）在两组之间或多或少相似。
与常规方案相比，IVF 可用于对 IUI 周期反应过度的女性，具有良好的妊娠率和较低的成本，因此在某些情况下可以被认为更适合患者。
