Ovulation induction: comparing success rates between anovulatory and ovulatory cycles using different treatment protocols

Abstract

The management of patients with sub-fertility, particularly unexplained sub-fertility, is a sensitive and complex matter. This was a prospective observational study conducted from October 2016 to March 2017 in Galway, Ireland, the aim of which was to identify the clinical pregnancy rates (CPR) in women undergoing ovulation induction (OI) with timed sexual intercourse (TSI) or intrauterine insemination (IUI) and to compare them across two groups: (1) Anovulatory women and (2) ovulatory women with unexplained subfertility. Patients undergoing OI were recruited consecutively and OI regimens were prescribed as per local clinical protocol. The main observation was a higher CPR in the anovulatory group (18%) compared with the ovulatory group (CPR = 10%) (p < 0.05). No difference was observed in the CPR between the TSI and IUI groups. There are many studies to support the use of OI in the treatment of women with anovulatory subfertility, though the use of OI in ovulatory women is a more controversial issue. The treatment options offered to these patients need to be individualized to each couple and should consider their length of infertility, age, and financial means. Due to the lower cost and the less invasive nature of OI-treatment we conclude that a short treatment course could be offered as an acceptable alternative prior to IVF.

摘要

管理生育力低下, 尤其是无法解释的生育力低下的患者是一件敏感而复杂的事情。这是一项于2016年10月至2017年3月在爱尔兰戈尔韦进行的前瞻性观察性研究, 目的是确定接受促排卵（OI）治疗, 定时性交（TSI）或宫腔内人工授精（IUI）的女性的临床妊娠率（CPR）。并在两组之间进行比较：（1）无排卵的女性和（2）具有无法解释的生育力低下的有排卵的女性。连续招募接受促排卵的患者, 并根据当地临床规程规定选择促排卵方案。主要观察结果是, 与排卵组（CPR = 10％）相比, 无排卵组患者CPR较高（18％）（p <0.05）。 TSI组和IUI组之间的​​CPR无明显差异。尽管有许多研究支持在无排卵性不孕女性中使用促排卵治疗, 但在有排卵女性中使用促排卵药物是一个颇具争议性的问题。为这些患者提供的治疗方案需要针对每对夫妇进行个性化选择, 并应考虑他们的不孕时间, 年龄和经济状况。由于促排卵治疗的成本较低且侵入性较小, 因此我们得出结论, 可以在IVF之前提供较短程的促排卵治疗作为可接受的替代方案。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Ovulation induction
• anovulatory subfertility
• ovulatory subfertility

Disclosure statement

No potential conflict of interest was reported by the authors.