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Volume 77, Issue 4, Pages 715-720 (April 2002)


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Conversion of high-response gonadotropin intrauterine insemination cycles to in vitro fertilization results in excellent ongoing pregnancy rates

Presented in part at the 56th Annual Meeting of the American Society for Reproductive Medicine, October 21–26, 2000, San Diego, California.

Amy M Antman, B.A.a, Joseph A Politch, Ph.D.a, Elizabeth S Ginsburg, M.D.Corresponding Author Informationaemail address

Received 17 May 2001; received in revised form 22 October 2001; accepted 22 October 2001.

Abstract 

Objective: To determine whether conversion of gonadotropin/IUI cycles at high risk of high-order multiple pregnancies to IVF yields a pregnancy rate high enough to warrant the added intervention.

Design: Case-control study.

Setting: Brigham and Women’s Hospital assisted reproductive technology program.

Patient(s): Seventy-seven patients converted from gonadotropin/IUI to IVF, 77 consecutive age and attempt number–matched controls (sequential controls [SCs]), and 77 consecutive age-, attempt-, and E2-matched controls (E2 controls [ECs]).

Interventions(s): Gonadotropin/IUI cycles with exuberant responses were converted to IVF (cases) to avoid cycle cancellation and high-order multiple pregnancies.

Main Outcome Measure(s): Pregnancy rates, delivery rates, E2 levels, follicle and oocyte number, and fertilization and implantation rates.

Result(s): Compared with SCs and ECs, cases had more follicles (16.3 ± 0.6 vs. 13.3 ± 0.9 and 14.4 ± 0.9) and higher E2 at hCG administration (1,951 ± 93 vs. 1,568 ± 96 and 1,939 ± 89 pg/mL). Delivery rates among the three groups (45.5% vs. 32.5% and 39.0%) did not differ significantly. Despite the transfer of fewer embryos in cases than in controls (2.5 ± 0.1 vs. 3.1 ± 0.1 and 2.9 ± 0.1), three triplet pregnancies occurred in cases and three in controls.

Conclusion(s): Conversion of high responder gonadotropin/IUI patients to IVF is an effective alternative to cycle cancellation and offers a delivery rate as high or higher per cycle than that of planned IVF. Sample size limited the statistical power of the study.

a Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA

Corresponding Author InformationReprint requests: Elizabeth Ginsburg, M.D., Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, 75 Francis St., Boston, Massachusetts, USA 02115 (FAX: 617-566-7752)

PII: S0015-0282(01)03244-7


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