Azargoon Azam, Bahrami Marjan, Alavy Toussy Jafar
Department of Infertility, Amir-AL-Momenin Hospital, Semnan University of Medical Sciences, Semnan, Iran.
Iran J Reprod Med. 2013 Mar;11(3):243-8.
Different protocols are used for controlled ovarian hyper stimulation (COH), but the optimal method has not yet been determined.
The aim of this study was to compare the outcome of controlled ovarian stimulation (COS) using clomiphen citrate (CC) plus HMG versus CC plus rFSH in intra uterine insemination cycles (IUI).
144 women with unexplained or male factor infertility undergoing IUI cycles were randomized (72 patients in CC plus rFSH group and 72 patients in CC plus HMG group) and included in this single blind study from October 2006 to June 2010. The primary outcomes were clinical and ongoing pregnancy rates. The number of dominant follicles, mean of follicular size, endometrial thickness on the day of HCG administration, total dose of gonadotropins and duration of stimulation with gonadotropins were secondary outcomes.
Clinical and ongoing pregnancy rates were not significantly different in the two groups .There was a significant higher multiple pregnancy rate in CC plus rFSH group (33.3%) versus CC plus HMG group (12.5%; p<0.005). There were no statistically significant differences in the secondary outcomes between the two groups.
According to our results it seems that CC plus HMG is a more suitable and cost-effective regimen than CC plus rFSH in IUI cycles in patients with unexplained or male factor infertility.
控制性卵巢过度刺激（COH）采用不同方案，但最佳方法尚未确定。
本研究旨在比较枸橼酸氯米芬（CC）联合人绝经期促性腺激素（HMG）与CC联合重组促卵泡生成素（rFSH）在子宫内人工授精（IUI）周期中控制性卵巢刺激（COS）的效果。
2006年10月至2010年6月，144例不明原因或男方因素不孕且接受IUI周期治疗的女性被随机分组（CC联合rFSH组72例患者，CC联合HMG组72例患者）并纳入本单盲研究。主要结局指标为临床妊娠率和持续妊娠率。优势卵泡数量、卵泡平均大小、注射人绒毛膜促性腺激素（HCG）当天的子宫内膜厚度、促性腺激素总剂量以及促性腺激素刺激持续时间为次要结局指标。
两组的临床妊娠率和持续妊娠率无显著差异。CC联合rFSH组的多胎妊娠率（33.3%）显著高于CC联合HMG组（12.5%；p<0.005）。两组次要结局指标无统计学显著差异。
根据我们的结果，对于不明原因或男方因素不孕的患者，在IUI周期中，CC联合HMG似乎比CC联合rFSH是更合适且更具成本效益的方案。
