Timur GÜRGAN, Aygül DEMİROL, Erkin KENT

Kontrollü over stimülasyonu ve intrauterin inseminasyon vakalarında tek veiki kez inseminasyon yapılmasının karşılaştırılması

ÖZET: Amaç: Kontrollü over stimülasyonu (KOH) ve intrauterin inseminasyon (IUI) yapılan vakalarda tek ve iki kez IUI yapılmasının etkinliklerinin karşılaştırılması. Gereç ve yöntem: KOH + IUI programına alınan 120 vakada KOH tedavisi rec FSH (Puregon, Organon) ile yapıldı. En fazla 3 adet 16 mm ve üzerinde dominant follikül tespit edildiğinde hCG (Pregnyl, 10.000 IU, Organon) verilerek ovülasyon zamanlaması yapıldı ve 1. grupta (60 hasta) hCG verilmesini takiben 36 saat sonra tek IUI işlemi uygulandı. 2. grupta (60 hasta) hCG verilmesini takiben 18 saat ve 36 saat sonra iki kez IUI işlemi uygulanmıştır. Çalışma prospektif olarak yapılmıştır. Her iki grupta klinik gebelik oranları karşılaştırılmıştır. Sonuçlar: Her iki grupta hCG günü ortalama dominant follikül sayıları arasında fark yok idi (1. grupta 2.1, 2. grupta 1.8; P>0.05). Klinik gebelik oranları arasında her iki grup arasında istatistiksel anlamlı bir fark izlenmedi ( 1. grupta %13.4, 2. grupta %16.6; p>0.05).

Comparison of single and double intrauterine insemination in controlled ovarian hyperstimulation cases

ABSTRACT: Objective: To compare the cycle outcome of single and double intrauterine insemination (IUI) following controlled ovulation induction (COH). Material and methods: One hundred twenty patients having ovulation induction with recFSH (Puregon, Organon) therapy prospectively evaluated; the patients in group 1 (60 patients) underwent single IUI , 36 hours after the administration of hCG (10,000 IU, Pregnyl, Organon) and the patients in group 2 (60 patients) underwent double IUI, 18 hours and 36 hours after the administration of hCG. Clinical pregnancy rates were compared between the groups. Results: There was no difference between the groups in terms of dominant follicle number on the hCG day (2.1 in group 1 and 1.8 in group 2; p>0.05). There was no significant difference with respect to the clinical pregnancy rates in both groups (13.4% in group 1 and 16.6% in group 2; p>0.05)

PDF

___

1- Hughes EG. The effectiveness of ovulation induction and intrauterine insemination in the treatment of persistent infertility: a meta-analysis. Hum Reprod 1997; 12, 1865- 1872.
2- Hecht BR, Magoon MW. Can the epidemic of iatrogenic multiples be conquered? Clin Obstet Gynecol. 1998;41,126-37.
3- Guzick, D.S., Carson S. A., Coutifaris, C. et al. ()Efficacy of Superovulation and Intrauterine Insemination in the Treatment of Infertility N. Eng J. Med 1999, 340, 177-183.
4- Tredway, D.R., Chan. P., Henig I, I. et al. (1990) Effectiviness of stimulated menstrual cycles and Percoll sperm preparation in intrauterine insemination. J. Reprod Med, 35: 103-108.
5- Matorras, R., Perez, C., Corcostegui, B. et al. (1997) Treatment of the male with follicle stimulation hormone in intrauterine insemination with husband’s spematozoa : a randomised study. Hum. Reprod, 12, 24-28.
6- Ecochard, R., Mathieu, C., Royere, D. et al. (2000) A randomised prospective study comparing pregnancy rates after clomiphene citrate and human menopausal gonadotropin before intrauterine insemination. Fertil Steril, 73, 90-93.
7- Zeyneloglu HB, Arici A, Olive DL, Duleba AJ (1998) Comparison of intrauterine insemination with timed intercourse in superovulated cycles with gonadotropins: a meta-analysis. Fertility Sterility 69, 486-491.
8- Silverberg KM, Johnson JV, Olive DL, Burns WN, Schenken RS A prospective, randomized trial comparing two different intrauterine insemination regimens in controlled ovarian hyperstimulation cycles. Fertil Steril 1992, 57, 357-61.
9- Ransom MX, Blotner MB, Bohrer M et al. Does increasing frequency of intrauterine insemination improve pregnancy rates significantly during superovulation cycles? Fertil Steril. 1994, 61, 303-7.
10- Ragni G, Maggioni P, Guermandi E, Testa A et al. Efficacy of double intrauterine insemination in controlled ovarian hyperstimulation cycles. Fertil Steril 1999, 72, 619- 22.
11- Abbasi R, Kenigsberg D, Danforth D, Falk RJ, Hodgen GD. Cumulative ovulation rate in human menopausal/human chorionic gonadotropin—treated monkeys: step up versus step down regimens. Fertil Steril 1987, 47, 1019-24.
12- Templeton AA, Van Look P, Angell RE, Aitken RJ et al. Oocyte recovery and fertilization rates in women at various times after administration of hCG. J Reprod Fertil 1996, 76, 771-8.
13- Weathersbee PS, Werlin LB, Stone SC. Peritoneal recovery of sperm after intrauterine insemination. Fertil Steril 1984, 42, 322-5.
14- Ripps BA, Mihnas BS, Carson SA, Buster JE. Intrauterine insemination in fertile women delivers larger numbers of sperm to the peritoneal fluid than intracervical insemination. Fertil Steril 1994, 61,398–400.
15- Carmen O, Roberto M., Jose I,Francisco J. Rodrı´guez-Escudero. One versus two inseminations per cycle in intrauterine insemination with sperm from patients’ husbands: a systematic review of the literature. Fertil Steril 2004, 82, 17-24.