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Controlled Ovarian Hyperstimulation with Intrauterine Insemination Is More Successful After r-hCG Administration Than Spontaneous LH Surge

BACKGROUND: The purpose of this study was to evaluate whether clinical pregnancy rate is affected by timing intrauterine insemination (IUI) according to serum LH surge, r-hCG trigger, or a combination of LH surge and r-hCG trigger in controlled ovarian hyperstimulation (COH) cycles for patients with...

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Autores principales: Taerk, Evan, Hughes, Edward, Greenberg, Cassandra, Neal, Michael, Amin, Shilpa, Faghih, Mehrnoosh, Karnis, Megan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Avicenna Research Institute 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641441/
https://www.ncbi.nlm.nih.gov/pubmed/29062796
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author Taerk, Evan
Hughes, Edward
Greenberg, Cassandra
Neal, Michael
Amin, Shilpa
Faghih, Mehrnoosh
Karnis, Megan
author_facet Taerk, Evan
Hughes, Edward
Greenberg, Cassandra
Neal, Michael
Amin, Shilpa
Faghih, Mehrnoosh
Karnis, Megan
author_sort Taerk, Evan
collection PubMed
description BACKGROUND: The purpose of this study was to evaluate whether clinical pregnancy rate is affected by timing intrauterine insemination (IUI) according to serum LH surge, r-hCG trigger, or a combination of LH surge and r-hCG trigger in controlled ovarian hyperstimulation (COH) cycles for patients with a variety of infertility etiologies. METHODS: The last 365 consecutive COH-IUI cycles performed at ONE Fertility Burlington in 2014 were reviewed and categorized according to method of IUI timing. Associations between categorical variables were analyzed using a combination of Chi-square and Fisher’s Exact tests, and between continuous variables using independent sample t-tests and logistic regression to a level of significance of p<0.05. RESULTS: The overall clinical pregnancy rate in this sample was 18.1% (66/365). Administration of r-hCG prior to IUI resulted in a higher clinical pregnancy rate compared with spontaneous serum LH surge: 18.2% vs. 5.8%, p=0.012. Patients in whom r-hCG was administered concomitantly with a serum LH surge had a higher clinical pregnancy than the r-hCG trigger group (30.8% vs. 18.2%, p=0.004) and LH surge group (30.8% vs. 5.8%, p<0.001). A sub-group analysis revealed that patients receiving r-FSH, rather than clomiphene or letrozole, had a significantly higher clinical pregnancy rate after r-hCG trigger as compared to the LH surge group (21.7% vs. 2.1%, p=0.01). CONCLUSION: In subfertile couples undergoing COH-IUI, r-hCG administration was associated with an increased clinical pregnancy rate compared with spontaneous serum LH surge. When r-hCG was administered concomitantly with a serum LH surge, this benefit was amplified. The effect appears to be of particular importance in r-FSH-medicated cycles.
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spelling pubmed-56414412017-10-23 Controlled Ovarian Hyperstimulation with Intrauterine Insemination Is More Successful After r-hCG Administration Than Spontaneous LH Surge Taerk, Evan Hughes, Edward Greenberg, Cassandra Neal, Michael Amin, Shilpa Faghih, Mehrnoosh Karnis, Megan J Reprod Infertil Original Article BACKGROUND: The purpose of this study was to evaluate whether clinical pregnancy rate is affected by timing intrauterine insemination (IUI) according to serum LH surge, r-hCG trigger, or a combination of LH surge and r-hCG trigger in controlled ovarian hyperstimulation (COH) cycles for patients with a variety of infertility etiologies. METHODS: The last 365 consecutive COH-IUI cycles performed at ONE Fertility Burlington in 2014 were reviewed and categorized according to method of IUI timing. Associations between categorical variables were analyzed using a combination of Chi-square and Fisher’s Exact tests, and between continuous variables using independent sample t-tests and logistic regression to a level of significance of p<0.05. RESULTS: The overall clinical pregnancy rate in this sample was 18.1% (66/365). Administration of r-hCG prior to IUI resulted in a higher clinical pregnancy rate compared with spontaneous serum LH surge: 18.2% vs. 5.8%, p=0.012. Patients in whom r-hCG was administered concomitantly with a serum LH surge had a higher clinical pregnancy than the r-hCG trigger group (30.8% vs. 18.2%, p=0.004) and LH surge group (30.8% vs. 5.8%, p<0.001). A sub-group analysis revealed that patients receiving r-FSH, rather than clomiphene or letrozole, had a significantly higher clinical pregnancy rate after r-hCG trigger as compared to the LH surge group (21.7% vs. 2.1%, p=0.01). CONCLUSION: In subfertile couples undergoing COH-IUI, r-hCG administration was associated with an increased clinical pregnancy rate compared with spontaneous serum LH surge. When r-hCG was administered concomitantly with a serum LH surge, this benefit was amplified. The effect appears to be of particular importance in r-FSH-medicated cycles. Avicenna Research Institute 2017 /pmc/articles/PMC5641441/ /pubmed/29062796 Text en Copyright© 2017, Avicenna Research Institute. http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Taerk, Evan
Hughes, Edward
Greenberg, Cassandra
Neal, Michael
Amin, Shilpa
Faghih, Mehrnoosh
Karnis, Megan
Controlled Ovarian Hyperstimulation with Intrauterine Insemination Is More Successful After r-hCG Administration Than Spontaneous LH Surge
title Controlled Ovarian Hyperstimulation with Intrauterine Insemination Is More Successful After r-hCG Administration Than Spontaneous LH Surge
title_full Controlled Ovarian Hyperstimulation with Intrauterine Insemination Is More Successful After r-hCG Administration Than Spontaneous LH Surge
title_fullStr Controlled Ovarian Hyperstimulation with Intrauterine Insemination Is More Successful After r-hCG Administration Than Spontaneous LH Surge
title_full_unstemmed Controlled Ovarian Hyperstimulation with Intrauterine Insemination Is More Successful After r-hCG Administration Than Spontaneous LH Surge
title_short Controlled Ovarian Hyperstimulation with Intrauterine Insemination Is More Successful After r-hCG Administration Than Spontaneous LH Surge
title_sort controlled ovarian hyperstimulation with intrauterine insemination is more successful after r-hcg administration than spontaneous lh surge
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641441/
https://www.ncbi.nlm.nih.gov/pubmed/29062796
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