TY - JOUR
T1 - Follicle stimulating hormone or clomiphene citrate in intrauterine insemination with ovarian stimulation for unexplained subfertility
T2 - a role for treatment selection markers?
AU - SUPER Study group
AU - Danhof, N A
AU - van Eekelen, R
AU - Repping, S
AU - Mol, B W J
AU - van der Veen, F
AU - van Wely, M
AU - Mochtar, M H
N1 - Copyright © 2019 Reproductive Healthcare Ltd. All rights reserved.
PY - 2019/6
Y1 - 2019/6
N2 - RESEARCH QUESTION: Can women be identified, on the basis of baseline patient characteristics, as having better chances of an ongoing pregnancy with FSH instead of clomiphene citrate as stimulation agent in intrauterine insemination for unexplained subfertility?DESIGN: A secondary analysis of a multicentre randomized controlled superiority trial; the SUPER study. Between July 2013 and March 2016, couples with unexplained subfertility undergoing intrauterine inemination (IUI) were allocated to an FSH or clomiphene citrate group. Female age, body mass index, duration of subfertility, primary versus secondary subfertility, antral follicle count and total motile count were assessed. For each of these factors, a logistic regression model was developed to assess if different estimated effects of FSH versus clomiphene citrate on ongoing pregnancy occurred within strata of each factor.RESULTS: A total of 684 couples received 2259 IUI cycles; 338 couples were allocated to FSH, of which 84 conceived leading to ongoing pregnancy and 346 couples were allocated to clomiphene citrate, of which 71 conceived leading to ongoing pregnancy. None of the treatment selection markers was associated with better ongoing pregnancy chances after IUI with FSH compared with clomiphene citrate.CONCLUSION: In couples with unexplained subfertility undergoing IUI, no baseline treatment selection markers could be identified to determine whether ovaries should be stimulated with FSH or clomiphene citrate.
AB - RESEARCH QUESTION: Can women be identified, on the basis of baseline patient characteristics, as having better chances of an ongoing pregnancy with FSH instead of clomiphene citrate as stimulation agent in intrauterine insemination for unexplained subfertility?DESIGN: A secondary analysis of a multicentre randomized controlled superiority trial; the SUPER study. Between July 2013 and March 2016, couples with unexplained subfertility undergoing intrauterine inemination (IUI) were allocated to an FSH or clomiphene citrate group. Female age, body mass index, duration of subfertility, primary versus secondary subfertility, antral follicle count and total motile count were assessed. For each of these factors, a logistic regression model was developed to assess if different estimated effects of FSH versus clomiphene citrate on ongoing pregnancy occurred within strata of each factor.RESULTS: A total of 684 couples received 2259 IUI cycles; 338 couples were allocated to FSH, of which 84 conceived leading to ongoing pregnancy and 346 couples were allocated to clomiphene citrate, of which 71 conceived leading to ongoing pregnancy. None of the treatment selection markers was associated with better ongoing pregnancy chances after IUI with FSH compared with clomiphene citrate.CONCLUSION: In couples with unexplained subfertility undergoing IUI, no baseline treatment selection markers could be identified to determine whether ovaries should be stimulated with FSH or clomiphene citrate.
KW - Adult
KW - Clomiphene/therapeutic use
KW - Data Interpretation, Statistical
KW - Female
KW - Fertility Agents, Female
KW - Fertilization in Vitro
KW - Follicle Stimulating Hormone/therapeutic use
KW - Humans
KW - Infertility, Female/therapy
KW - Insemination, Artificial, Homologous/methods
KW - Insemination, Artificial/methods
KW - Ovulation Induction/methods
KW - Pregnancy
KW - Pregnancy Outcome
KW - Pregnancy Rate
KW - Treatment Outcome
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85064068756&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30981620
U2 - https://doi.org/10.1016/j.rbmo.2019.01.014
DO - https://doi.org/10.1016/j.rbmo.2019.01.014
M3 - Article
C2 - 30981620
SN - 1472-6483
VL - 38
SP - 938
EP - 942
JO - Reproductive BioMedicine Online
JF - Reproductive BioMedicine Online
IS - 6
ER -