Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2012, 156(2):159-163 | DOI: 10.5507/bp.2012.044
The efficacy of conversion from IUI to IVF-ET in infertility patients with hyper-response to ovulation induction: A retrospective study
- a Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China, 510080
- b Guangdong No.2 Provincial People's Hospital, Guangzhou, China, 510000
Background: The aim of the study was to determine the efficacy of in vitro fertilization and embryo transfer (IVF-ET) in patients with hyper-response to ovulation induction for intrauterine insemination (IUI).
Methods: Patients with polycystic ovary syndrome (PCOS) who were initially treated with IUI in our centre between Jan 2007 and Oct 2010 were retrospectively analyzed. The ovarian hyper-stimulation syndrome (OHSS) found in 50 patients was then treated with IVF-ET following informed consent.
Results: The fresh transfer had 42 cycles and a total of 87 embryos were transferred. Urine pregnancy tests were positive in 15 patients and fetal heart beat was detected in 12 patients by transvaginal ultrasound, from which 3 patients had two fetuses, 2 patients had three fetuses, and 7 patients had a single fetus. The overall clinical pregnancy rate was 28.5% (12/42) for the fresh embryo transfer. A total of 21 cycles of frozen embryo transfer with up to 55 embryos were conducted for patients who were not pregnant at the end of fresh embryo transfer cycles or who did not receive fresh embryo transfer in the first place. Urine pregnancy tests were positive in 10 patients and fetal heart beat was detected in 8 patients. The clinical pregnancy rate was 38.1% (8/21) for frozen embryo transfer.
Conclusion: We conclude that IVF-ET is an effective method for patients with hyper-response to ovulation induction in IUI.
Keywords: polycystic ovary syndrome, in vitro fertilization and embryo transfer, ovulation induction, intrauterine insemination
Received: September 9, 2011; Accepted: April 12, 2012; Published: June 1, 2012 Show citation
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References
- Karande VC, Korn A, Morris R, Rao R, Balin M, Rinehart J, Dohn K, Gleicher N. Prospective randomized trial comparing the outcome and cost of in vitro fertilization with that of a traditional treatment algorithm as first-line therapy for couples with infertility. Fertil Steril 1999;71:468-75.
Go to original source...
Go to PubMed... - Pashayan N, Lyratzopoulos G, Mathur R. Cost-effectiveness of primary offer of IVF vs. primary offer of IUI followed by IVF (for IUI failures) in couples with unexplained or mild male factor subfertility. BMC Health Serv Res 2006;6:80.
Go to original source...
Go to PubMed... - Guzick DS, Sullivan MW, Adamson GD, Cedars MI, Falk RJ, Peterson EP, Steinkampf MP. Efficacy of treatment for unexplained infertility. Fertil Steril 1998;70:207-13.
Go to original source...
Go to PubMed... - Nisker J, Tummon I, Daniel S, Kaplan B, Yuzpe A. Conversion of cycles involving ovarian hyperstimulation with inteuterine insemination to in-vitro fertilisation. Human Reproduction 1994;9(3):406-8.
Go to original source...
Go to PubMed... - Antman AM, Politch JA, Ginsburg ES. Conversion of high-response gonadotropin intrauterine insemination cycles to in-vitro fertilization results in excellent ongoing pregnancy rates. Fertil Steril 2002;77:715-22.
Go to original source...
Go to PubMed... - Tummon IS, Asher JL, Martin JSB, Tulandi T. R a ndomized controlled trial of superovulation and insemination for infertility associated with minimal or mild endometriosis. F e rtil Steril 1997;68:8
Go to original source...
Go to PubMed... - Haydardedeoglu B, Bagis T, Simsek E, Cok T, Hacivelioglu SO, Erkanli S. The impact of rescue in vitro fertilization converted from highresponse gonadotropin intrauterine insemination cycles in terms of implantation and pregnancy rates as compared with matched controls. Fertil Steril 2009;92:137-42.
Go to original source...
Go to PubMed... - Olufowobi O, Sharif K, Papaioannou S, Mohamed H, Neelakantan D, Afnan M. Role of rescue IVF-ET treatment in the management of high response in stimulated IUI cycles. J Obstet Gynaecol 2005;25:166-8.
Go to original source...
Go to PubMed... - Schenker JG, Yarkoni S, Granat M. Multiple pregnancies following induction of ovulation. Fertil Steril 1981;35:105-23.
Go to original source...
Go to PubMed... - Callahan TL, Hall JE, Ettner SL, Christiansen CL, Greene MF, Crowley WF Jr. The economic impact of multiple-gestation pregnancies and the contribution of assisted-reproduction techniques to their incidence. N Engl J Med 1994;331:244-9.
Go to original source...
Go to PubMed... - Valbuena D, Simón C, Romero JL, Remohí J, Pellicer A. Factors responsible for multiple pregnancies after ovarian stimulation and intrauterine insemination with gonadotropins. J Assist Reprod Genet 1996;13:663-8.
Go to original source...
Go to PubMed... - Zarrilli S, Paesano L, Colao A, Mirone V, Lombardi G, De Rosa M. FSH treatment improves sperm function in patients after varicocelectomy. J Endocrinol Invest. 2000;23(2):68-73.
Go to original source...
Go to PubMed... - Guanglun Z. Modern assisted reproductive technology. Beijing: People's Medical Publishing House, 2005. p132-4.
- Xianhong T. The natural cycle of IVF - ET in assisted reproductive technology in the application . Foreign family planning/reproductive health branch 2006;25(1):18-9.
- De Geyter C, De Geyter M, Nieschlag E. Low multiple pregnancy rates and reduced frequency of cancellation after ovulation induction with gonadotropins, if eventual supernumerary follicles are aspirated to prevent polyovulation. J Assist Reprod Genet 1998;15:111-6.
Go to original source...
Go to PubMed... - Kun-ming L, Xiao-ming T, Hui-fen C, Fan Y, Zhi-qin C, Li-ping Z, Jianzhi Y, Yu W, Jia-ping P, Jing-yu S. Preliminary Discussion of Patients of Multi-follicle Development during Induced Ovulation Altered to IVF-ET or Mature Follicle Puncture +IUI. Reproduc contracep 2008;28(6):1-5.




