Multiple Pregnancy after Gonadotropin-Intrauterine Insemination: An Unavoidable Event?

Fong, S.; Palta, Vidya; Oh, Cheongeun; Cho, Michael M.; Loughlin, Jacquelyn S.; McGovern, Peter G.

doi:10.5402/2011/465483

Cited by 8 publications

(5 citation statements)

References 15 publications

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“…Multiple pregnancy can be prevented by careful monitoring of the number of follicles larger than 12 mm during ovulation induction. Recent data suggests that cancelation of cycles should be considered when estradiol levels are > 1200 pg/mL or there is an excessive number (≥ 5) of developing follicles [102]. When more than 3 follicles > 14 mm are observed, cancelation should be seriously considered.…”

Section: Ovarian Stimulation Risksmentioning

confidence: 99%

Polycystic ovary syndrome throughout a woman’s life

Bellver

Rodríguez-Tabernero

Robles

et al. 2017

J Assist Reprod Genet

130

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Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among reproductive-aged women and the main cause of infertility due to anovulation. However, this syndrome spans the lives of women affecting them from in-utero life until death, leading to several health risks that can impair quality of life and increase morbidity and mortality rates. Fetal programming may represent the beginning of the condition characterized by hyperandrogenism and insulin resistance which leads to a series of medical consequences in adolescence, adulthood, and old age. Menstrual and fertility problems evolve into metabolic complications as age advances. An early and precise diagnosis is important for an adequate management of PCOS, especially at the extreme ends of the reproductive lifespan. However, many different phenotypes are included under the same condition, being important to look at these different phenotypes separately, as they may require different treatments and have different consequences. In this way, PCOS exhibits a great metabolic complexity and its diagnosis needs to be revised once again and adapted to recent data obtained by new technologies. According to the current medical literature, lifestyle therapy constitutes the first step in the management, especially when excess body weight is associated. Pharmacotherapy is frequently used to treat the most predominant manifestations in each age group, such as irregular menses and hirsutism in adolescence, fertility problems in adulthood, and metabolic problems and risk of cancer in old age. Close surveillance is mandatory in each stage of life to avoid health risks which may also affect the offspring, since fetal and post-natal complications seem to be increased in PCOS women.

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Section: Ovarian Stimulation Risksmentioning

confidence: 99%

Polycystic ovary syndrome throughout a woman’s life

Bellver

Rodríguez-Tabernero

Robles

et al. 2017

J Assist Reprod Genet

130

View full text Add to dashboard Cite

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“…The peak oestrogen level and the number of follicles with a diameter >16 mm are significant factors for IUI success 18 . Younger women, shorter duration of infertility, and higher peak oestrogen level predict successful outcome in IUI 20 . In the present study, oestrogen level was not a significant factor for pregnancy, probably owing to the small sample size.…”

Section: Discussionmentioning

confidence: 99%

“…Oestrogen level reflects ovarian reserve and growing of follicles and is associated with IUI outcome 8,[18][19][20] . Peak oestrogen level is higher in successful cycles 8 .…”

Section: Discussionmentioning

confidence: 99%

Effect of endometrial thickness on pregnancy outcome in intrauterine insemination: a retrospective study

Leung

2020

Hong Kong Journal of Gynaecology, Obstetrics and Midwifery

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Background: Intrauterine insemination (IUI) is a management option for infertility. We aimed to investigate the association between endometrial thickness (ET) and pregnancy outcome after IUI, and to identify factors affecting outcome in a Hong Kong population. Methods: Medical records of women who underwent IUI at the infertility clinic of Queen Elizabeth Hospital from January 2013 to June 2019 were reviewed. Only the first cycle was included in the analysis to avoid overrepresentation of patients who failed treatment. Patients with or without clinical pregnancy were compared, as were patients with or without ongoing pregnancy. The predictive power of ET for pregnancy in IUI was assessed using the area under the receiver operating characteristic curve. Proportions of clinical pregnancy and ongoing pregnancy were calculated for 3 different subgroups of ET (<7 mm, 7-10 mm, and >10 mm). Results: Of 337 IUI cycles, the clinical pregnancy rate was 12.7% (n=43); the ongoing pregnancy rate was 10.6% (n=36); and the multiple pregnancy rate was 1.4% (n=5). Shorter duration of infertility was associated with clinical pregnancy (2.67 years vs 3.51 years, p=0.003) and ongoing pregnancy (2.64 years vs 3.50 years, p=0.001). ET was not predictive of clinical pregnancy or ongoing pregnancy, with the area under the receiver operating characteristics curve being 0.473 and 0.509, respectively. Highest clinical and ongoing pregnancy rates occurred in those with ET of >10 mm. In patients with ET of >10 mm, all patients with clinical pregnancy successfully carried on to ongoing pregnancy. Conclusion: ET is not predictive of IUI success. Longer duration of infertility adversely affects IUI outcome.

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“…Evidence-Based Care for Couples With Infertility I N F O C U S CNE higher-order multiple gestations are a result of IVF and ART, 38% are from ovulation-inducing drugs, and 20% are spontaneous; efforts to identify risk factors so cycles can be cancelled have not been successful (Fong et al, 2011). The challenge occurs when patients want to transfer more embryos to increase the odds of success.…”

Section: Educational Considerationsmentioning

confidence: 99%