Conversion from assisted reproductive technology to intrauterine insemination in low responders: Is it advantageous?

被引:10
|
作者
Norian, John M. [1 ,2 ]
Levens, Eric D. [2 ]
Richter, Kevin S. [2 ]
Widra, Eric A. [2 ]
Levy, Michael J. [2 ]
机构
[1] Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, Program Reprod & Adult Endocrinol, NIH, CRC, Bethesda, MD 20892 USA
[2] Shady Grove Fertil Reprod Sci Ctr, Rockville, MD USA
基金
美国国家卫生研究院;
关键词
ART; oocyte retrieval; intrauterine insemination; poor response; FERTILIZATION; FOLLICLES; CYCLES; LESS;
D O I
10.1016/j.fertnstert.2009.12.056
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To examine cycle outcomes among patients demonstrating an attenuated ovarian response that proceeded to oocyte retrieval to those converted to intrauterine insemination (IUI). Design: Retrospective cohort study. Setting: Large private fertility center. Patient(s): First planned autologous assisted reproductive technology (ART) cycles among women demonstrating a poor ovarian response to hyperstimulation (<= 4 follicles >= 14 mm, peak E-2 <1,000 IU/L at hCG administration). Intervention(s): Oocyte retrieval or IUI conversion. Main Outcome Measure(s): Live birth and clinical pregnancy. Result(s): A total of 269 IUI conversions and 167 oocyte retrievals followed a poor ovarian response to gonadotropins among first planned ART cycles. Number of follicles >= 14 mm (2.3 vs. 3.5) and peak E-2 levels (555 vs. 743 pg/mL) were lower for IUI conversions compared with those proceeding to ART. Peak E-2 was similar between groups after adjusting for follicle number (IUI: 611 pg/mL; ART: 652 pg/mL). Stimulation response was similar between treatment groups with equivalent follicle numbers. Undergoing oocyte retrieval was associated with significantly improved pregnancy (odds ratio [OR] 3.6, 95% confidence interval [CI] 1.8-7.4) and live birth outcome (OR 3.5, 95% CI 1.7-8.0) after adjusting for age and follicle number. Conclusion(s): Among women demonstrating a poor ovarian response to gonadotropins, proceeding with planned ART resulted in significantly higher pregnancy rates than converting these cycles to IUI. (Fertil Steril (R) 2010; 94: 2073-7. (C) 2010 by American Society for Reproductive Medicine.)
引用
收藏
页码:2073 / 2077
页数:5
相关论文
共 50 条
  • [1] IS SUPEROVULATION AND INTRAUTERINE INSEMINATION REALLY AN ALTERNATIVE TO ASSISTED REPRODUCTIVE TECHNOLOGY
    DODSON, WC
    SEMINARS IN REPRODUCTIVE ENDOCRINOLOGY, 1995, 13 (01): : 85 - 89
  • [2] Cost-effectiveness analysis comparing continuation of assisted reproductive technology with conversion to intrauterine insemination in patients with low follicle numbers
    Yu, Bo
    Mumford, Sunni
    Royster, G. Donald
    Segars, James
    Armstrong, Alicia Y.
    FERTILITY AND STERILITY, 2014, 102 (02) : 435 - 439
  • [3] Evaluation and Treatment of Low Responders in Assisted Reproductive Technology: A Challenge to Meet
    Sozos J. Fasouliotis
    Alex Simon
    Neri Laufer
    Journal of Assisted Reproduction and Genetics, 2000, 17 : 357 - 373
  • [4] Evaluation and treatment of low responders in assisted reproductive technology: A challenge to meet
    Fasouliotis, SJ
    Simon, A
    Laufer, N
    JOURNAL OF ASSISTED REPRODUCTION AND GENETICS, 2000, 17 (07) : 357 - 373
  • [5] Intrauterine insemination with ovarian stimulation is a successful step prior to assisted reproductive technology for couples with unexplained infertility
    Osmanlioglu, Seyma
    Sukur, Yavuz Emre
    Tokgoz, Vehbi Yavuz
    Ozmen, Batuhan
    Sonmezer, Murat
    Berker, Bulent
    Aytac, Rusen
    Atabekoglu, Cem Somer
    JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 2022, 42 (03) : 472 - 477
  • [6] MICROMANIPULATIVE AND CONVENTIONAL INSEMINATION STRATEGIES FOR ASSISTED REPRODUCTIVE TECHNOLOGY
    TUCKER, MJ
    AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1995, 172 (02) : 773 - 778
  • [7] Failure of intrauterine insemination as rescue treatment in low responders with adequate HCG timing with no oocytes retrieved
    Matorras, Roberto
    Aparicio, Victoria
    Corcostegui, Beatriz
    Prieto, Begona
    Mendoza, Rosario
    Ramon, Olga
    Gomez-Picado, Oihane
    Exposito, Antonia
    REPRODUCTIVE BIOMEDICINE ONLINE, 2014, 29 (05) : 634 - 639
  • [8] Association of corpus luteum activity in early pregnancy and live birth after assisted reproductive technology (ART) and intrauterine insemination (IUI)
    Hiller, R. A. F.
    Thieme, S.
    Bauer, L. C.
    Schultze-Mosgau, A.
    Depenbusch, M.
    Eggersmann, T. K.
    Griesinger, G.
    HUMAN REPRODUCTION, 2024, 39
  • [9] Efficacy and safety of intrauterine insemination and assisted reproductive technology in populations serodiscordant for human immunodeficiency virus: a systematic review and meta-analysis
    Barnes, Arti
    Riche, Daniel
    Mena, Leandro
    Sison, Therese
    Barry, Lauren
    Reddy, Raveena
    Shwayder, James
    Parry, John Preston
    FERTILITY AND STERILITY, 2014, 102 (02) : 424 - 434
  • [10] Effectiveness and safety of intrauterine insemination vs. assisted reproductive technology emulating a target trial using an observational database of administrative claims
    Chiu, Yu-Han
    Yland, Jennifer J.
    Rinaudo, Paolo
    Hsu, John
    McGrath, Sean
    Hernandez-Diaz, Sonia
    Hernan, Miguel A.
    FERTILITY AND STERILITY, 2022, 117 (05) : 981 - 991