Role of Dominant Follicle Count in Controlled Ovarian Stimulation With Intrauterine Insemination Cycles in Patients With Unexplained Infertility

Abstract

Objective:The aim of the present study was to determine the predictive value of dominant follicle count as a marker for pregnancy and multiple pregnancy rate in controlled ovarian hyperstimulation (COH) with intrauterine insemination (IUI) cycles in couples with unexplained subfertility. Material and Methods:The study was designed as a prospective non-randomized trial and involving 214 women with unexplained infertility was underwent COH-IUI at a University of Mersin School of Medicine, Obstetric and Gynecology department between May 2008 and September 2010.Results: Of 532 COH cycles started, 513 were completed and resulted in 62 clinical pregnancies (12.1% per completed cycle). There were 9 (14.5%) multiple pregnancies and 7 (11.3%) miscarriages. In cycles with a single, two and three dominant follicles (>16 mm) on the day of hCG the clinical pregnancy rate were 8.3%, 14.7% and 27.1% respectively. Three dominant follicles (>16 mm) count have increased pregnancy rate more than the 1 or 2 (p value 0.001 and 0.044 respectively). In addition cycles with a single, two and three dominant follicles the multiple pregnancy rate were 7.4%, 15.8% and 25% respectively. The multiple pregnancy rate was similar in cycles with 1 and 2 dominant follicles and lower than three (p:0.004). Conclusion:Three follicular growths are associated with increased pregnancy rates in COH-IUI women with unexplained subfertility. In cycles with one or two follicles, the multiple pregnancy rates are not significantly different however 3 dominant follicles associated with increased multiple pregnancy rates.