Sebnem EROL TÜRKYILMAZ, Gürcan TÜRKYILMAZ, Murat APİ

GONADOTROPİNLERLE OVULASYON İNDÜKSİYONU VE İNTRAUTERİN İNSEMİNASYON YAPILAN AÇIKLANMAYAN İNFERTİL ÇİFTLERDE HCG GÜNÜ ENDOMETRİAL KALINLIK VE PATERNİNİN TEDAVİ BAŞARISINA ETKİSİ

Amaç: Kontrollü ovulasyon indüksiyonu ve intrauterin inseminasyon (OI-IUI) tüm dünyada infertil çiftlerde ilk basamak tedavi olarak kullanılmaktadır. Bu çalışmada OI-IUI yapılan nedeni belirlenemeyen infertilite olgularında Hcg günü değerlendirilen endometrial kalınlık ve paternin tedavi başarısına etkisini inceledik.Materyel-metod: Bu çalışmada Şubat 2013-Eylül 2013 tarihleri arasında nedeni belirlenemeyen infertilite tanısı alan 101 çift ve132 IUI siklusu prospektif olarak incelendi.Bulgular: 132 siklusta 22 gebelik elde edildi ve siklus başına gebelik oranı %16.6 hasta başına gebelik oranı %21.7 olarak hesaplandı. Gebelik pozitif ve negatif olan grupta kullanılan FSH dozu, stimülasyon süresi, bazal FSH, bazal E2, TPMSS, IUI siklus sayısı, folikül çapı arasında anlamlı farklılık saptanmadı. Gebelik pozitif olan grupta infertilite süresi 2.1±1.4 yıl gebelik negatif olan grupta 4.1±2.3 yıldı ve bu fark anlamlı olarak daha kısaydı (p < 0,05). Gebelik pozitif olan grupta antral folikül sayısı ve hCG günü folikül sayısı gebelik negatif olan gruptan anlamlı (p < 0.05) olarak daha yüksekti. Hcg günü yapılan endometrial değerlendirmede gebelik elde edilen grupta 9.8±1.1 mm, gebelik elde edilemeyen grupta ise 9.6±3.5 mm ölçüldü ve endometrial kalınlığın veya endometrium paterninin her iki grup arasında anlamlı farklılık göstermediği görüldü.Sonuç: İnfertilite tedavisinde OI-IUI uygulanan hastalarda hCG günü ölçülen endometrial kalınlık ve endometrial paternin gebelik oranlarını etkilemediği görüldü.

Anahtar Kelimeler:

infertilite, ovulasyon indüksiyonu, endometriyum

THE EFFECT OF THICKNESS AND PATTERN OF ENDOMETRIUM ON SUCCESS RATE ON HCG DAY IN INFERTILE COUPLES TREATED WITH OVULATION INDUCTION VIA GONADOTROPINS AND INTRAUTERINE INSEMINATION

Aim: Ovulation induction and intrauterine insemination is the first line therapy chosen for infertile couples. In this study, we investigated the effect of endometrial thickness and endometrial pattern; examined on HCG day, on the success rate of OI-IUI performed in unexplained infertility cases on the day of HCG.Material and Method: In this study 101 couples and 132 IUI cycle who were diagnoses unexplained infertility were examined prospectively.Results: 22 successful pregnancy was achieved in 132 cycles, the rate of pregnancy was calculated as %16.6 per cycle and %21.7 per patient. There was no significant difference between clinically proved pregnancy-positive and negative outcome groups regarding FSH dosage, duration of stimulation, basal FSH level, basal E2, TPMSS, number of IUI cycle, follicle diameter. Infertility period was calculated as 2.1 ± 1.4 years, and 4.1 ± 2.3 years positive and negative outcome groups respectively. The difference was statistically significant (p < 0.05). The number of an antral follicle and follicle count on HCG day was significantly different on pregnancy positive group compared to pregnancy negative group (p< 0.05). Endometrial thickness was measured as 9.8±1.1 mm and 9.6±3.5 mm in groups with positive and negative outcomes respectively. There was no significant difference regarding endometrial thickness and endometrial pattern. Result: There was no significant difference between pregnancy clinically proven and unproven groups in terms of endometrial thickness and endometrial pattern on the day HCG performed.

Keywords:

infertility, ovulation induction, endometrium,

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