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Low Multiple Pregnancy Rates and Reduced Frequency of Cancellation After Ovulation Induction with Gonadotropins, If Eventual Supernumerary Follicles Are Aspirated to Prevent Polyovulation

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Abstract

Purpose: Our purpose was to demonstrate the feasibility of the routine aspiration of supernumerary follicles in infertile patients with imminent polyovulation after ovulation induction with gonadotropins and to examine its effect on the frequency of cycle cancellation and on the (multiple) pregnancy rate.

Methods: The data on 796 treatment cycles, performed between 1989 and 1996 on 410 infertile couples, were analyzed retrospectively. From October 1992, whenever necessary, supernumerary ovarian follicles were selectively aspirated transvaginally under ultrasound guidance to prevent the ovulation of more than three follicles. Thereafter, intrauterine insemination was performed.

Results: After the adoption of transvaginal ultrasound-guided aspiration of supernumerary follicles into the treatment protocol in October 1992, the number of canceled cycles (P < 0.0001) and the multiple pregnancy rate (P < 0.01) were significantly reduced compared to those previously. The overall pregnancy rate remained stable. No ovarian hyperstimulation syndrome requiring hospitalization was noted, and no complications resulting from the follicle aspiration were registered.

Conclusions: Transvaginal ultrasound-guided aspiration of supernumerary ovarian follicles increases both the efficacy and the safety of ovulation induction with gonadotropins. Because of the limited equipment required, this method represents an alternative for conversion of overstimulated cycles to more costly alternatives such as in vitro fertilization.

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Authors and Affiliations

  1. Woman's Hospital of the University, Albert-Schweitzer-Straße 33, D-48129 Münster, Germany. Department of Obstetrics and Gynecology, Division of Endocrinology and Reproductive Medicine, CH-4031, Basel, Switzerland

    Christian De Geyter

  2. Institute of Reproductive Medicine of the University, Domagkstraße 11, D-48129, Münster, Germany

    Maria De Geyter & Eberhard Nieschlag

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  1. Christian De Geyter
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  2. Maria De Geyter
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  3. Eberhard Nieschlag
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De Geyter, C., De Geyter, M. & Nieschlag, E. Low Multiple Pregnancy Rates and Reduced Frequency of Cancellation After Ovulation Induction with Gonadotropins, If Eventual Supernumerary Follicles Are Aspirated to Prevent Polyovulation. J Assist Reprod Genet 15, 111–116 (1998). https://doi.org/10.1023/A:1023000719569

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  • DOI: https://doi.org/10.1023/A:1023000719569

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