Abstract
Purpose
This retrospective, descriptive study was designed to determine the effectiveness of using clomiphene citrate in relatively high daily doses (100, 150, and 200 mg) with simplified monitoring for in vitro fertilization in a private office and surgical center. The self-selected study population comprised 109 women who were 25–42 years old, including 26 women whose husbands had mild male-factor infertility.
Results
During January 1992 through December 1993, 165 stimulation cycles resulted in 137 egg retrievals, 24 clinical pregnancies (17.5%), and 20 viable pregnancies (14.5%). Cycles that could not be completed (28/165 or 16.9% of all cycles) involved luteinizing hormone surges, insufficient follicles, or low estradiol levels. There were no pregnancies in patients who were 40 years or older or who received 200 mg daily doses of clomiphene citrate. The viable pregnancy rate among patients with male factor infertility was 7.7% (2/26). For non-male-factor infertility patients who were younger than 40, the viable pregnancy rate was 17.6% (18/102).
Conclusion
The simplified monitoring method did not appear to compromise the results.
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References
Steptoe PC, Edwards RG: Birth after the reimplantation of a human embryo. Lancet 1978;2:366
Trounson AO, Leeton JF, Wood C, Webb J, Wood J: Pregnancies in human by fertilization in vitro and embryo transfer in the controlled ovulatory cycle. Science 1981;212:681–682
Kruger TF, Acosta AA, Simmons KF, Swanson RJ, Matta JF, Oehninger S: Predictive value of abnormal sperm morphology in in vitro fertilization. Fertil Steril 1988;49:112
Fossum GT, Vermesh M, Kletzky OA: Biochemical and biophysical indices of follicular development in spontaneous and stimulated ovulatory cycles. Obstet Gynecol 1990;75:407–411
Templeton A, Messinis IE, Baird DT: Characteristics of ovarian follicles in spontaneous and stimulated cycles in which there was an endogenous luteinizing hormone surge. Fertil Steril 1986;46:1113–1117
Hecht BR, Khan-Dawood FS, Dawood MY: The luteinizing hormone surge: Timing and characteristics in the plasma and urine after clomiphene citrate treatment. Fertil Steril 1989;52:401–405
Bieglmayer C, Fischl F, Janisch H: Evaluation of a simple and fast self-test for urine luteinizing hormone. Fertil Steril 1990;53:842–846
Tucker MJ, Wiker SR, Wright G, Morton PC, Toledo AA: Treatment of male infertility and idiopathic failure to fertilize in vitro with under zona insemination and direct egg injection. Am J Obstet Gynecol 1993;169:324–332
Tucker MJ, Ingargiola PE, Massey JB, Morton PC, Wiemer KE, Wiker SR, Wright G: Assisted hatching with or without bovine oviductal epithelial cell coculture for poor prognosis patients. Hum Reprod 1994;9:1528–1531
Steinkampf MP, Kretzer PA, McElroy E, Conway-Myers BA: A simplified approach to in vitro fertilization. J Reprod Med 1992;37:199–204
Corfman RS, Milad MP, Bellavance TL, Ory SJ, Erickson LD, Ball GD: A novel ovarian stimulation protocol for use with the assisted reproductive technologies. Fertil Steril 1993;60:864–870
Fishel SB, Edwards RG, Purdy JM: Analysis of 25 infertile patients treated consecutively by in vitro fertilization at Bourn Hall. Fertil Steril 1984;42:191–197
Vargyas JM, Morente C, Shangold G, Marrs RP: The effect of different methods of ovarian stimulation for human in vitro fertilization and embryo replacement. Fertil Steril 1984;42:745–749
Quigley MM, Schmidt CL, Beauchamp PJ, Pace-Owens S, Berkowitz AS, Wolf DP: Enhanced follicular recruitment in an in vitro fertilization program: Clomiphene alone versus clomiphene/human menopausal gonadotropin combination. Fertil Steril 1984;42:25–33
Fossum GT, Davidson A, Paulson RJ: Ovarian hyperstimulation inhibits embryo implantation in the mouse. J Vitro Fert Embryo Transfer 1989;6:7–10
Paulson RJ, Sauer MV, Lobo RA: Embryo implantation following human in vitro fertilization: Importance of endometrial receptivity. Fertil Steril 1990;53:870–874
Paulson RJ, Sauer MV, Francis MM, Macaso TM, Lobo RA: Embryo implantation after in vitro fertilization (IVF) in unstimulated cycles. 39th Annual Meeting of the Pacific Coast Fertility Society, Indian Wells, CA, 1991, Abstr 0-001
Patton PE: IVF in the unstimulated cycle. Contemp Ob/Gyn 1992;67–74
Foulot H, Ranoux C, Dubuisson JB, Rambaud D, Aubriot FX, Poirot C: In vitro fertilization without ovarian stimulation: A simplified protocol applied in 80 cycles. Fertil Steril 1989;52:617–621
Paulson RJ, Sauer MV, Francis MM, Macaso TM, Lobo RA: In vitro fertilization in unstimulated cycles: A clinical trial using hCG for timing of follicle aspiration. Obstet Gynaecol 1990;76:788–791
Burry KA, Hickok LR, Patton PE, Dubois P, Fickett C: Preliminary experience with natural cycle in vitro fertilization. 39th Annual Meeting of the Pacific Coast Fertility Society, Indian Wells, CA, 1991;0-001, 10–14
Mathieson J, Risquez F, Perez J, Zorn JR: Spontaneous cycles and in vitro fertilization. II Joint ESCO-ESHRE meeting, Milan, Italy, 1990, Abst 341
Hoult IJ, Crespigny LC, O'Herlihy C, Speirs AL, Lopata A, Kellow G, Johnston I, Robinson HP: Ultrasound control of clomiphene/human chorionic gonadotropin stimulated cycles for oocyte recovery and in vitro fertilization. Fertil Steril 1981;36:316–319
Claman P, Domingo M, Garner P, Leader A, Spence JEH: Natural cycle in vitro fertilization-embryo transfer at the University of Ottawa: An inefficient therapy for tubal infertility. Fertil Steril 1993;60:298–302
Taymor ML, Ranoux CJ, Gross GL: Natural oocyte retrieval with intravaginal fertilization: A simplified approach to in vitro fertilization. Obstet Gynecol 1992;80:888–891
Johns DA: Clomiphene citrate-induced gamete intrafallopian transfer with diagnostic and operative laparoscopy. Fertil Steril 1991;56:311–313
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Massey, J.B., Ingargiola, P.E., Tucker, M.J. et al. Minimal stimulation with simplified monitoring for in vitro fertilization. J Assist Reprod Genet 11, 353–358 (1994). https://doi.org/10.1007/BF02214141
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DOI: https://doi.org/10.1007/BF02214141