Systematic review of the treatment of ovulatory infertility with clomiphene citrate and intrauterine insemination

Costello, Michael

doi:10.1111/j.1479-828x.2004.00192.x

Cited by 39 publications

(29 citation statements)

References 37 publications

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“…It has been shown in many studies in the literature that the use of FSH and hMG is superior to CC use (24)(25)(26)(27). Although we observed that gestational rates were low in the CC group, we could not show the difference due to the small sample size.…”

Section: Discussioncontrasting

confidence: 55%

Factors affecting clinical pregnancy rates after IUI for the treatment of unexplained infertility and mild male subfertility

Atasever¹,

Kalem²,

Hatırnaz³

et al. 2016

J Turkish German Gynecol Assoc

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Objective:The aim of the present retrospective study was to evaluate intrauterine insemination (IUI) clinical experiences and to define the variables for predicting success. Material and Methods:The present study was an observational trial performed in a private IVF center on subfertile couples who had applied for treatment between 2002 and 2012, in which the data of 503 IUI cases were retrospectively reviewed. Couples who had been diagnosed with unexplained and mild male subfertility were included. The primary outcome measure was the clinical pregnancy rate in an attempt to form a predictive model for the odds of a clinical pregnancy. Recorded parameters were used to determine the prediction model. Results:Utilizing univariate logistic regression analysis, clinical pregnancy was positively associated with the duration of infertility (OR=1.09, p=0.089), secondary infertility (OR=1.77, p=0.050), and +4 sperm motility after preparation (OR=1.03, p=0.091). Following an adjustment analysis involving a multivariate logistic regression, clinical pregnancy was still found to positively associate with secondary infertility (OR=2.51, p=0.008). Conclusion:IUI success in secondary infertile couples who were in the unexplained infertility and mild male subfertility groups was higher than that in primary infertile couples, and the chances of pregnancy increased as sperm numbers with +4 motility increased. It is difficult to concomitantly evaluate all these parameters and to determine a predictive parameter in IUI independent from other factors. (J Turk Ger Gynecol Assoc 2016; 17: 134-8) Keywords: Intrauterine insemination, unexplained infertility, male subfertility Received: 1 April, 2016 Accepted: 25 July, 2016 Factors affecting clinical pregnancy rates after IUI for the treatment of unexplained infertility and mild male subfertility

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Section: Discussioncontrasting

confidence: 55%

Factors affecting clinical pregnancy rates after IUI for the treatment of unexplained infertility and mild male subfertility

Atasever¹,

Kalem²,

Hatırnaz³

et al. 2016

J Turkish German Gynecol Assoc

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“…Yapılan çalışmalarda, IUI uygulanan sikluslarda klomifen sitrat ve rFSH kullanımı ile gerçekleşen gebelik oranları karşılaştırılmış, her iki grupta da siklus başına devam eden gebelik oranları arasında fark bulunamamıştır (11,12). Yapılan bir derlemede klomifen sitrat ile birlikte IUI uygulananlarda, doğal sikluslarda planlanmış cinsel ilişkilere göre daha yüksek oranda gebelik olduğu bildirilmiştir (13). Balasch ve ark.…”

Section: Discussionunclassified

“…Başka bir çalışmada ise, IUI sikluslarında gebelik oranları hMG grubunda (%19), klomifen sitrat grubuna (%4) göre daha yüksek tespit edilmiştir (5). Yapılan bir meta-analizde, gonadotropin + IUI sikluslarında gebelik oranlarının klomifen sitrat + IUI sikluslarına göre anlamlı olarak daha fazla olduğu bildirilmiştir (13). Eş spermi ile yapılan IUI sikluslarında klomifen sitrat ve gonadotropinleri karşılaştıran meta-analizde, gebelik oranlarının gonadotropin grubunda daha yüksek olduğu bildirilmiştir (14).…”

Section: Discussionunclassified

A comparison on the Intrauterine Insemination Outcomes of Infertile Women Undergoing Ovulation Induction with Clomiphene Citrate and rFSH

Yıldız¹,

Çim²,

Elçi³

et al. 2016

Van Med J

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“…Some studies have reported a modest benefit of IUI in women with minimal and mild endometriosis [51][52][53][54][55] (Table 2). In particular, IUI with controlled ovarian stimulation (COS) resulted in increases in pregnancy rate compared with expectant management in a few large RCTs and in a large population study [56][57][58]. The results of an RCT performed by Tummon et compared with timed intercourse during the natural cycle (OR 4.6, 95% CI 1.9-11.3) [57].…”

Section: Assisted Reproductive Technology In Women With Endometrimentioning

confidence: 99%

“…In particular, IUI with controlled ovarian stimulation (COS) resulted in increases in pregnancy rate compared with expectant management in a few large RCTs and in a large population study [56][57][58]. The results of an RCT performed by Tummon et compared with timed intercourse during the natural cycle (OR 4.6, 95% CI 1.9-11.3) [57]. Clinical pregnancy rate using IUI with COS after surgical management for stage I/II endometriosisis comparable to the rate associated with unexplained infertility.…”

Section: Assisted Reproductive Technology In Women With Endometrimentioning

confidence: 99%

Management of Endometriosis-Associated Infertility

2014

J Androl Gynaecol

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Endometriosis is a common, chronic disease. Patients typically present with pelvic pain, infertility, and/or an adnexal mass. Results from the limited number of studies that have been published indicate that the true prevalence of endometriosis, along with the associated infertility, has been increasing. Debates about infertility management arise from the contradiction between the contraceptive nature of medical treatments for endometriosis and the unpredictable ovarian reserve after surgery. There is moderate quality evidence that surgery increases clinical pregnancy rate and live birth in minimal to mild endometriosis. However, insufficient evidences which supports the effect of surgery in moderate to severe endometriosis in term of subfertility. On this basis, artificial reproductive technologies have been become the most efficient way of overcoming endometriosisassociated infertility, particularly in stage III/IV endometriosis. The objective of this paper is to review recent trends in endometriosis, from the pathophysiology of the disease to the management of infertility.endometriosis and infertility and to assess the current approaches and management modalities used for infertile women with endometriosis. PathophysiologyAs previously mentioned, how endometriosis contributes to infertility remains controversial. However, there are a few hypotheses that describe the pathophysiology of endometriosis-associated infertility when the endometriotic lesion is located in the pelvic cavity, ovary, or uterus [8]. Distorted Pelvic AnatomyPelvic adhesions that develop as a consequence of endometriosis can interfere with ovulation, transport of the oocyte or ovum, and pick-up by the fimbriae. The oviducts may be patent bilaterally, but existing adhesions around the adnexa can interrupt the dynamic movements of the fimbriae that are necessary for oocyte uptake [9]. Altered Peritoneal MilieuThe chronic inflammatory status of the pelvic cavity in endometriosis patients has been recognized for decades. This inflammation is accompanied by increased infiltration of macrophages in the pelvic fluid. The pathophysiology has not been well-described, but increased recruitment of immune cells and dysregulated apoptosis of endometrial cells present in the lesion are thought to be contributing factors. Additional support for this hypothesis arises from the observation that in addition to the macrophages, inflammatory cytokines, and prostaglandins, chemokines stimulate and aggregate monocytes and granulocytes. RANTES [10], monocyte inflammatory protein-1 [11,12] IntroductionEndometriosis is a disease characterized by ectopic endometrial glands and stromal tissue external to the uterine cavity. The prevalence of the disease has been reported to be 5-10% in women of reproductive age, 20-30% in women diagnosed with infertility, and 40-60% in women with chronic pelvic pain [1]. Fecundity, the probability of giving live birth in a menstrual cycle, has been shown to be 0.02-0.1 per month in women with endometriosis, but is 0.15-0.2 ...

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Systematic review of the treatment of ovulatory infertility with clomiphene citrate and intrauterine insemination

Abstract: Clomiphene citrate combined with IUI is more effective than timed intercourse in the natural cycle at achieving pregnancy in couples with ovulatory infertility. However, treatment with gonadotrophins and IUI is superior to CC and IUI.

Cited by 39 publications

References 37 publications

Factors affecting clinical pregnancy rates after IUI for the treatment of unexplained infertility and mild male subfertility

Factors affecting clinical pregnancy rates after IUI for the treatment of unexplained infertility and mild male subfertility

A comparison on the Intrauterine Insemination Outcomes of Infertile Women Undergoing Ovulation Induction with Clomiphene Citrate and rFSH

Management of Endometriosis-Associated Infertility

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