IngentaConnect Prediction of chances for success or complications in gonadotroph...

Authors: Annemarie G.M.G.J. Mulders¹; Marinus J.C. Eijkemans²; Babak Imani³; Bart C.J.M. Fauser¹

Source: Reproductive BioMedicine Online, Volume 7, Number 2, September 2003 , pp. 170-178(9)

Publisher: Reproductive Healthcare Ltd

Abstract:

This follow-up study evaluated whether initial screening characteristics predict treatment outcome of gonadotrophin induction of ovulation. One hundred and fifty-four women with normogonadotrophic anovulatory infertility for whom clomiphene citrate induction of ovulation was unsuccessful were included in the present study. Daily FSH injections were initiated on day 3-5 after spontaneous or progestagen-induced withdrawal bleeding. In most patients, a dose finding low-dose step-up regimen was applied during the first treatment cycle in order to identify the individual FSH response dose. In all subsequent cycles, a step-down protocol was applied. Initial serum concentrations of LH, testosterone and androstenedione were significant predictors for the probability of multi-follicular development. FSH treatment resulted in a total of 67 (44%) ongoing pregnancies. Comparing those women who did, versus those who did not, achieve an ongoing pregnancy in a multivariate Cox regression analysis, initial serum insulin-like growth factor-I (IGF-I), testosterone and women's age entered into the final model (AUC = 0.67). The individual treatment outcome following gonadotrophin induction of ovulation may be predicted by initial screening characteristics.

Keywords: anovulation; exogenous gonadotrophin induction of ovulation; follow-up studies; infertility; polycystic ovary syndrome; prediction model

Document Type: Research article

Affiliations: 1: Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus Medical Centre, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands 2: Centre for Clinical Decision Sciences, Department of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands 3: Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus Medical Centre, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands

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Prediction of chances for success or complications in gonadotrophin ovulation induction in normogonadotrophic anovulatory infertility