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Bart C J M Fauser - One of the best experts on this subject based on the ideXlab platform.
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follicle stimulating hormone receptor polymorphism affects the outcome of Ovulation Induction in normogonadotropic world health organization class 2 anovulatory subfertility
Fertility and Sterility, 2015Co-Authors: O Valkenburg, Bart C J M Fauser, Evert J P Van Santbrink, T E Konig, Axel P N Themmen, Andre G Uitterlinden, Cornelis B Lambalk, Joop S E LavenAbstract:Objective To assess whether an FSH receptor polymorphism (Asn680Ser, rs6166) can affect the outcome of Ovulation Induction in normogonadotropic (World Health Organization class 2 [WHO2]) anovulatory subfertile women. Design Prospective, longitudinal, cohort study. Setting University-based fertility unit. Patient(s) A total of 240 consecutive women diagnosed with WHO2 anovulatory subfertility who underwent Ovulation Induction therapy. Results were replicated in a retrospective cohort of 185 patients with polycystic ovary syndrome (PCOS) (Rotterdam criteria). Intervention(s) Ovulation Induction using clomiphene citrate (CC) as first-line and exogenous gonadotropins (exFSH) as second-line therapy. Main Outcome Measure(s) Clomiphene-resistant anOvulation (CRA), clomiphene failure (CCF), and ongoing pregnancy rate. Result(s) Genotyped patients (n = 159) were similar to nongenotyped women (n = 81) regarding clinical characteristics and outcomes of Ovulation Induction. The 680 Ser allele was associated with CRA. A pooled analysis of both cohorts showed an 89% higher chance of CRA after CC treatment (odds ratio 1.9 [95% confidence interval 1.1–3.3]) in homozygous carriers of the FSH receptor variant (680 Ser/Ser ). A lower chance of ongoing pregnancy (hazard ratio 0.51 [95% confidence interval 0.27–0.98]) was observed among these patients during CC treatment in the prospective cohort. Conclusion(s) An FSH receptor polymorphism is associated with CRA during treatment with clomiphene citrate. These data may be used to design a treatment algorithm that is more efficacious and better tailored to the individual patient.
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reproductive endocrinology revisiting Ovulation Induction in pcos
Nature Reviews Endocrinology, 2014Co-Authors: Bart C J M FauserAbstract:Polycystic ovary syndrome (PCOS) is associated with anovulatory infertility. Many clinicians focus on the use of assisted reproductive technologies other than medical Induction of Ovulation. A new study demonstrating that the aromatase inhibitor letrozole is superior to clomiphene citrate (the current first-line therapy) for Ovulation Induction in women with PCOS returns attention to this area.
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high singleton live birth rate confirmed after Ovulation Induction in women with anovulatory polycystic ovary syndrome validation of a prediction model for clinical practice
Fertility and Sterility, 2012Co-Authors: Susanne M Veltmanverhulst, Bart C J M Fauser, Marinus J C EijkemansAbstract:Objective To evaluate the cumulative singleton live birth rate after classic Ovulation Induction in women with anovulatory polycystic ovary syndrome and to validate a previously developed prediction model. Design Prospective follow-up study. Setting Tertiary infertility unit. Patient(s) Validation cohort of 108 treatment-naive anovulatory PCOS patients. Intervention(s) Conventional Ovulation Induction, applying clomiphene citrate as first-line treatment, followed by exogenous gonadotropins as second-line intervention. Main Outcome Measure(s) Singleton live birth prediction. Model calibration and discrimination were assessed for the initial model (variables included age, duration of infertility, and insulin/glucose ratio) and a second model in which the insulin/glucose ratio was replaced by body mass index. Result(s) The cumulative singleton live birth rate after 12 and 24 months was 60% and 78%, respectively. Overall, the observed rates were higher than predicted: hazard ratio 1.21 (95% confidence interval [CI] 0.89, 1.64), first model and 1.25 (95% CI 1.20, 1.30), second model. However, the predictive capacity of the model variables was reliable, with calibration slopes of 0.79 (95% CI −0.04, 1.63) and 1.06 (95% CI 0.95, 1.18), respectively. Conclusion(s) The present study confirms the previously reported good treatment prognosis for women with PCOS undergoing classic Ovulation Induction. Women with a poor prognosis, for whom alternative treatment options may be considered, can best be identified by a prediction model including age, duration of infertility, and body mass index. Clinical Trial Registration Number NCT00821379.
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predictors of ovarian response progress towards individualized treatment in Ovulation Induction and ovarian stimulation
Human Reproduction Update, 2008Co-Authors: Bart C J M Fauser, K Diedrich, Paul DevroeyAbstract:Ovarian stimulation is applied in the clinic to restore mono-ovulatory cycles in anovulatory women (Ovulation Induction) or to induce the development of multiple dominant follicles for assisted reproduction. Ovarian response is the endocrine and follicular reaction of the ovaries to stimulation. Achieving an appropriate ovarian response to anti-estrogens or exogenous gonadotrophins is central to Ovulation Induction and ovarian stimulation protocols. However, achieving an adequate response, without cycle cancellation or adverse events related to under- or over-stimulation, is complicated by high intra- and inter-individual variability. To predict each patient's ovarian response to medication for ovarian stimulation and to individualize the starting dose of exogenous gonadotrophin or the need for exogenous luteinizing hormone, various clinical, endocrine, ovarian ultrasonographic and genetic characteristics have been explored. Some of these features have been incorporated into prediction models. In this review, the methodology behind predictive factors and prediction models and their potential clinical applicability across Ovulation Induction and ovarian stimulation are explored.
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Ovulation Induction in normogonadotropic anOvulation pcos
Best Practice & Research Clinical Endocrinology & Metabolism, 2006Co-Authors: Evert J P Van Santbrink, Bart C J M FauserAbstract:Treatment of normogonadotropic anovulatory infertility (World Health Organization class 2, or WHO2) is by Induction of Ovulation using clomiphene citrate (CC), followed by follicle-stimulating hormone (FSH) in cases of treatment failure. Not all patients will become ovulatory or will conceive with this treatment. Others, exhibiting multifollicular instead of monofollicular development, may encounter complications such as ovarian hyperstimulation and multiple pregnancy. Recently introduced alternative treatment interventions-such as insulin-sensitizing drugs, aromatase inhibitors, or laparoscopic electrocautery of the ovaries-may offer the possibility of improving the efficacy of the classical Ovulation Induction algorithm. Based on initial patient characteristics, it may be possible to identify specific patient subgroups with altered chances of success or complications while using one of these interventions. Regarding CC and FSH Ovulation Induction, this has been performed using multivariate prediction models. This approach may enable us to improve safety, cost-effectiveness, and patient convenience in future Ovulation Induction.
Micah J. Hill - One of the best experts on this subject based on the ideXlab platform.
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progesterone luteal support after Ovulation Induction and intrauterine insemination a systematic review and meta analysis
Fertility and Sterility, 2013Co-Authors: Micah J. Hill, Alan H. Decherney, Nancy Terry, Brian W Whitcomb, Terrence D Lewis, Mae Wu, Eric D Levens, A M PropstAbstract:Objective To evaluate the effect of progesterone (P) for luteal phase support after Ovulation Induction (OI) and intrauterine insemination (IUI). Design An updated systematic review and meta-analysis. Setting Not applicable. Patient(s) Patients undergoing OI-IUI for infertility. Intervention(s) Exogenous P luteal support after OI-IUI. Main Outcome Measure(s) Live birth. Result(s) Eleven trials were identified that met inclusion criteria and constituted 2,842 patients undergoing 4,065 cycles, more than doubling the sample size from the previous meta-analysis. In patients receiving gonadotropins for OI, clinical pregnancy (relative risk [RR] 1.56, 95% confidence interval [CI] 1.21–2.02) and live birth (RR 1.77, 95% CI 1.30–2.42) were more likely in P supplemented patients. These findings persisted in analysis of live birth per IUI cycle (RR 1.59, 95% CI 1.24–2.04). There were no data on live birth in clomiphene citrate or clomiphene plus gonadotropin cycles. There was no benefit on clinical pregnancy with P support for patients who underwent OI with clomiphene (RR 0.85, 95% CI 0.52–1.41) or clomiphene plus gonadotropins (RR 1.26, 95% CI 0.90–1.76). Conclusion(s) Progesterone luteal phase support is beneficial to patients undergoing Ovulation Induction with gonadotropins in IUI cycles. The number needed to treat is 11 patients to have one additional live birth. Progesterone support did not benefit patients undergoing Ovulation Induction with clomiphene citrate or clomiphene plus gonadotropins.
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progesterone luteal support after Ovulation Induction and intrauterine insemination a systematic review and meta analysis
Fertility and Sterility, 2013Co-Authors: Micah J. Hill, Alan H. Decherney, Nancy Terry, Brian W Whitcomb, Terrence D Lewis, Eric D Levens, A M PropstAbstract:Objective To evaluate the effect of luteal phase P support after Ovulation Induction IUI. Design A systematic review and meta-analysis. Setting Not applicable. Patient(s) Undergoing Ovulation Induction IUI. Intervention(s) Any form of exogenous P in Ovulation Induction IUI cycles. Main Outcome Measure(s) Clinical pregnancy and live birth. Result(s) Five trials were identified that met inclusion criteria and comprised 1,298 patients undergoing 1,938 cycles. Clinical pregnancy (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.15–1.98) and live birth (OR 2.11, 95% CI 1.21–3.67) were more likely in P-supplemented patients. These findings persisted in analyses evaluating per IUI cycle, per patient, and first cycle only data. In subgroup analysis, patients receiving gonadotropins for Ovulation Induction had the most increase in clinical pregnancy with P support (OR 1.77, 95% CI 1.20–2.6). Conversely, patients receiving clomiphene citrate (CC) for Ovulation Induction showed no difference in clinical pregnancy with P support (OR 0.89, 95% CI 0.47–1.67). Conclusion(s) Progesterone luteal phase support may be of benefit to patients undergoing Ovulation Induction with gonadotropins in IUI cycles. Progesterone support did not benefit patients undergoing Ovulation Induction with CC, suggesting a potential difference in endogenous luteal phase function depending on the method of Ovulation Induction.
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progesterone luteal support after Ovulation Induction and intrauterine insemination an updated systematic review and meta analysis
Fertility and Sterility, 2013Co-Authors: K A Green, Alan H. Decherney, Nancy Terry, Terrence D Lewis, Jessica R Zolton, Sophia M V Schermerhorn, Mae Wu Healy, Micah J. HillAbstract:Objective To evaluate the effect of luteal phase P support after Ovulation Induction IUI. Design A systematic review and meta-analysis. Setting Not applicable. Patient(s) Undergoing Ovulation Induction IUI. Intervention(s) Any form of exogenous P in Ovulation Induction IUI cycles. Main Outcome Measure(s) Clinical pregnancy and live birth. Result(s) Five trials were identified that met inclusion criteria and comprised 1,298 patients undergoing 1,938 cycles. Clinical pregnancy (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.15–1.98) and live birth (OR 2.11, 95% CI 1.21–3.67) were more likely in P-supplemented patients. These findings persisted in analyses evaluating per IUI cycle, per patient, and first cycle only data. In subgroup analysis, patients receiving gonadotropins for Ovulation Induction had the most increase in clinical pregnancy with P support (OR 1.77, 95% CI 1.20–2.6). Conversely, patients receiving clomiphene citrate (CC) for Ovulation Induction showed no difference in clinical pregnancy with P support (OR 0.89, 95% CI 0.47–1.67). Conclusion(s) Progesterone luteal phase support may be of benefit to patients undergoing Ovulation Induction with gonadotropins in IUI cycles. Progesterone support did not benefit patients undergoing Ovulation Induction with CC, suggesting a potential difference in endogenous luteal phase function depending on the method of Ovulation Induction.
A M Propst - One of the best experts on this subject based on the ideXlab platform.
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progesterone luteal support after Ovulation Induction and intrauterine insemination a systematic review and meta analysis
Fertility and Sterility, 2013Co-Authors: Micah J. Hill, Alan H. Decherney, Nancy Terry, Brian W Whitcomb, Terrence D Lewis, Mae Wu, Eric D Levens, A M PropstAbstract:Objective To evaluate the effect of progesterone (P) for luteal phase support after Ovulation Induction (OI) and intrauterine insemination (IUI). Design An updated systematic review and meta-analysis. Setting Not applicable. Patient(s) Patients undergoing OI-IUI for infertility. Intervention(s) Exogenous P luteal support after OI-IUI. Main Outcome Measure(s) Live birth. Result(s) Eleven trials were identified that met inclusion criteria and constituted 2,842 patients undergoing 4,065 cycles, more than doubling the sample size from the previous meta-analysis. In patients receiving gonadotropins for OI, clinical pregnancy (relative risk [RR] 1.56, 95% confidence interval [CI] 1.21–2.02) and live birth (RR 1.77, 95% CI 1.30–2.42) were more likely in P supplemented patients. These findings persisted in analysis of live birth per IUI cycle (RR 1.59, 95% CI 1.24–2.04). There were no data on live birth in clomiphene citrate or clomiphene plus gonadotropin cycles. There was no benefit on clinical pregnancy with P support for patients who underwent OI with clomiphene (RR 0.85, 95% CI 0.52–1.41) or clomiphene plus gonadotropins (RR 1.26, 95% CI 0.90–1.76). Conclusion(s) Progesterone luteal phase support is beneficial to patients undergoing Ovulation Induction with gonadotropins in IUI cycles. The number needed to treat is 11 patients to have one additional live birth. Progesterone support did not benefit patients undergoing Ovulation Induction with clomiphene citrate or clomiphene plus gonadotropins.
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progesterone luteal support after Ovulation Induction and intrauterine insemination a systematic review and meta analysis
Fertility and Sterility, 2013Co-Authors: Micah J. Hill, Alan H. Decherney, Nancy Terry, Brian W Whitcomb, Terrence D Lewis, Eric D Levens, A M PropstAbstract:Objective To evaluate the effect of luteal phase P support after Ovulation Induction IUI. Design A systematic review and meta-analysis. Setting Not applicable. Patient(s) Undergoing Ovulation Induction IUI. Intervention(s) Any form of exogenous P in Ovulation Induction IUI cycles. Main Outcome Measure(s) Clinical pregnancy and live birth. Result(s) Five trials were identified that met inclusion criteria and comprised 1,298 patients undergoing 1,938 cycles. Clinical pregnancy (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.15–1.98) and live birth (OR 2.11, 95% CI 1.21–3.67) were more likely in P-supplemented patients. These findings persisted in analyses evaluating per IUI cycle, per patient, and first cycle only data. In subgroup analysis, patients receiving gonadotropins for Ovulation Induction had the most increase in clinical pregnancy with P support (OR 1.77, 95% CI 1.20–2.6). Conversely, patients receiving clomiphene citrate (CC) for Ovulation Induction showed no difference in clinical pregnancy with P support (OR 0.89, 95% CI 0.47–1.67). Conclusion(s) Progesterone luteal phase support may be of benefit to patients undergoing Ovulation Induction with gonadotropins in IUI cycles. Progesterone support did not benefit patients undergoing Ovulation Induction with CC, suggesting a potential difference in endogenous luteal phase function depending on the method of Ovulation Induction.
Alan H. Decherney - One of the best experts on this subject based on the ideXlab platform.
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progesterone luteal support after Ovulation Induction and intrauterine insemination a systematic review and meta analysis
Fertility and Sterility, 2013Co-Authors: Micah J. Hill, Alan H. Decherney, Nancy Terry, Brian W Whitcomb, Terrence D Lewis, Eric D Levens, A M PropstAbstract:Objective To evaluate the effect of luteal phase P support after Ovulation Induction IUI. Design A systematic review and meta-analysis. Setting Not applicable. Patient(s) Undergoing Ovulation Induction IUI. Intervention(s) Any form of exogenous P in Ovulation Induction IUI cycles. Main Outcome Measure(s) Clinical pregnancy and live birth. Result(s) Five trials were identified that met inclusion criteria and comprised 1,298 patients undergoing 1,938 cycles. Clinical pregnancy (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.15–1.98) and live birth (OR 2.11, 95% CI 1.21–3.67) were more likely in P-supplemented patients. These findings persisted in analyses evaluating per IUI cycle, per patient, and first cycle only data. In subgroup analysis, patients receiving gonadotropins for Ovulation Induction had the most increase in clinical pregnancy with P support (OR 1.77, 95% CI 1.20–2.6). Conversely, patients receiving clomiphene citrate (CC) for Ovulation Induction showed no difference in clinical pregnancy with P support (OR 0.89, 95% CI 0.47–1.67). Conclusion(s) Progesterone luteal phase support may be of benefit to patients undergoing Ovulation Induction with gonadotropins in IUI cycles. Progesterone support did not benefit patients undergoing Ovulation Induction with CC, suggesting a potential difference in endogenous luteal phase function depending on the method of Ovulation Induction.
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progesterone luteal support after Ovulation Induction and intrauterine insemination a systematic review and meta analysis
Fertility and Sterility, 2013Co-Authors: Micah J. Hill, Alan H. Decherney, Nancy Terry, Brian W Whitcomb, Terrence D Lewis, Mae Wu, Eric D Levens, A M PropstAbstract:Objective To evaluate the effect of progesterone (P) for luteal phase support after Ovulation Induction (OI) and intrauterine insemination (IUI). Design An updated systematic review and meta-analysis. Setting Not applicable. Patient(s) Patients undergoing OI-IUI for infertility. Intervention(s) Exogenous P luteal support after OI-IUI. Main Outcome Measure(s) Live birth. Result(s) Eleven trials were identified that met inclusion criteria and constituted 2,842 patients undergoing 4,065 cycles, more than doubling the sample size from the previous meta-analysis. In patients receiving gonadotropins for OI, clinical pregnancy (relative risk [RR] 1.56, 95% confidence interval [CI] 1.21–2.02) and live birth (RR 1.77, 95% CI 1.30–2.42) were more likely in P supplemented patients. These findings persisted in analysis of live birth per IUI cycle (RR 1.59, 95% CI 1.24–2.04). There were no data on live birth in clomiphene citrate or clomiphene plus gonadotropin cycles. There was no benefit on clinical pregnancy with P support for patients who underwent OI with clomiphene (RR 0.85, 95% CI 0.52–1.41) or clomiphene plus gonadotropins (RR 1.26, 95% CI 0.90–1.76). Conclusion(s) Progesterone luteal phase support is beneficial to patients undergoing Ovulation Induction with gonadotropins in IUI cycles. The number needed to treat is 11 patients to have one additional live birth. Progesterone support did not benefit patients undergoing Ovulation Induction with clomiphene citrate or clomiphene plus gonadotropins.
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progesterone luteal support after Ovulation Induction and intrauterine insemination an updated systematic review and meta analysis
Fertility and Sterility, 2013Co-Authors: K A Green, Alan H. Decherney, Nancy Terry, Terrence D Lewis, Jessica R Zolton, Sophia M V Schermerhorn, Mae Wu Healy, Micah J. HillAbstract:Objective To evaluate the effect of luteal phase P support after Ovulation Induction IUI. Design A systematic review and meta-analysis. Setting Not applicable. Patient(s) Undergoing Ovulation Induction IUI. Intervention(s) Any form of exogenous P in Ovulation Induction IUI cycles. Main Outcome Measure(s) Clinical pregnancy and live birth. Result(s) Five trials were identified that met inclusion criteria and comprised 1,298 patients undergoing 1,938 cycles. Clinical pregnancy (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.15–1.98) and live birth (OR 2.11, 95% CI 1.21–3.67) were more likely in P-supplemented patients. These findings persisted in analyses evaluating per IUI cycle, per patient, and first cycle only data. In subgroup analysis, patients receiving gonadotropins for Ovulation Induction had the most increase in clinical pregnancy with P support (OR 1.77, 95% CI 1.20–2.6). Conversely, patients receiving clomiphene citrate (CC) for Ovulation Induction showed no difference in clinical pregnancy with P support (OR 0.89, 95% CI 0.47–1.67). Conclusion(s) Progesterone luteal phase support may be of benefit to patients undergoing Ovulation Induction with gonadotropins in IUI cycles. Progesterone support did not benefit patients undergoing Ovulation Induction with CC, suggesting a potential difference in endogenous luteal phase function depending on the method of Ovulation Induction.
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Nafarelin versus leuprolide in Ovulation Induction for in vitro fertilization: a randomized clinical trial.
Obstetrics and gynecology, 1992Co-Authors: Alan S Penzias, F N Shamma, J N Gutmann, E E Jones, Alan H. Decherney, Gad LavyAbstract:Gonadotropin-releasing hormone agonists vary in structure and route of administration. We performed this study to compare patient response to intranasal nafarelin acetate versus subcutaneous leuprolide acetate as adjuncts to Ovulation Induction for in vitro fertilization (IVF). Forty-two patients entering their first cycle of IVF were randomized to receive either nafarelin acetate or leuprolide acetate. Patient characteristics in the two groups did not differ significantly, nor did cycle cancellation rates or outcome. There was no significant difference in patient response as indicated by follicular phase serum levels of estradiol (E2), FSH, or LH, luteal phase E2, and progesterone. Luteal phase progesterone-dependent endometrial protein was significantly lower in those taking nafarelin acetate, though it remained in the normal range. However, those receiving nafarelin acetate required significantly less human menopausal gonadotropin (hMG) and had significantly more embryos frozen for later transfer than those receiving leuprolide acetate. Intranasal nafarelin acetate can be used successfully in Ovulation Induction regimens that include GnRH agonists. The use of nafarelin acetate may decrease a patient's hMG requirement and increase the number of frozen embryos available for later transfer as compared with leuprolide acetate. Further studies are needed to optimize the dosing regimen.
Terrence D Lewis - One of the best experts on this subject based on the ideXlab platform.
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progesterone luteal support after Ovulation Induction and intrauterine insemination a systematic review and meta analysis
Fertility and Sterility, 2013Co-Authors: Micah J. Hill, Alan H. Decherney, Nancy Terry, Brian W Whitcomb, Terrence D Lewis, Mae Wu, Eric D Levens, A M PropstAbstract:Objective To evaluate the effect of progesterone (P) for luteal phase support after Ovulation Induction (OI) and intrauterine insemination (IUI). Design An updated systematic review and meta-analysis. Setting Not applicable. Patient(s) Patients undergoing OI-IUI for infertility. Intervention(s) Exogenous P luteal support after OI-IUI. Main Outcome Measure(s) Live birth. Result(s) Eleven trials were identified that met inclusion criteria and constituted 2,842 patients undergoing 4,065 cycles, more than doubling the sample size from the previous meta-analysis. In patients receiving gonadotropins for OI, clinical pregnancy (relative risk [RR] 1.56, 95% confidence interval [CI] 1.21–2.02) and live birth (RR 1.77, 95% CI 1.30–2.42) were more likely in P supplemented patients. These findings persisted in analysis of live birth per IUI cycle (RR 1.59, 95% CI 1.24–2.04). There were no data on live birth in clomiphene citrate or clomiphene plus gonadotropin cycles. There was no benefit on clinical pregnancy with P support for patients who underwent OI with clomiphene (RR 0.85, 95% CI 0.52–1.41) or clomiphene plus gonadotropins (RR 1.26, 95% CI 0.90–1.76). Conclusion(s) Progesterone luteal phase support is beneficial to patients undergoing Ovulation Induction with gonadotropins in IUI cycles. The number needed to treat is 11 patients to have one additional live birth. Progesterone support did not benefit patients undergoing Ovulation Induction with clomiphene citrate or clomiphene plus gonadotropins.
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progesterone luteal support after Ovulation Induction and intrauterine insemination a systematic review and meta analysis
Fertility and Sterility, 2013Co-Authors: Micah J. Hill, Alan H. Decherney, Nancy Terry, Brian W Whitcomb, Terrence D Lewis, Eric D Levens, A M PropstAbstract:Objective To evaluate the effect of luteal phase P support after Ovulation Induction IUI. Design A systematic review and meta-analysis. Setting Not applicable. Patient(s) Undergoing Ovulation Induction IUI. Intervention(s) Any form of exogenous P in Ovulation Induction IUI cycles. Main Outcome Measure(s) Clinical pregnancy and live birth. Result(s) Five trials were identified that met inclusion criteria and comprised 1,298 patients undergoing 1,938 cycles. Clinical pregnancy (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.15–1.98) and live birth (OR 2.11, 95% CI 1.21–3.67) were more likely in P-supplemented patients. These findings persisted in analyses evaluating per IUI cycle, per patient, and first cycle only data. In subgroup analysis, patients receiving gonadotropins for Ovulation Induction had the most increase in clinical pregnancy with P support (OR 1.77, 95% CI 1.20–2.6). Conversely, patients receiving clomiphene citrate (CC) for Ovulation Induction showed no difference in clinical pregnancy with P support (OR 0.89, 95% CI 0.47–1.67). Conclusion(s) Progesterone luteal phase support may be of benefit to patients undergoing Ovulation Induction with gonadotropins in IUI cycles. Progesterone support did not benefit patients undergoing Ovulation Induction with CC, suggesting a potential difference in endogenous luteal phase function depending on the method of Ovulation Induction.
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progesterone luteal support after Ovulation Induction and intrauterine insemination an updated systematic review and meta analysis
Fertility and Sterility, 2013Co-Authors: K A Green, Alan H. Decherney, Nancy Terry, Terrence D Lewis, Jessica R Zolton, Sophia M V Schermerhorn, Mae Wu Healy, Micah J. HillAbstract:Objective To evaluate the effect of luteal phase P support after Ovulation Induction IUI. Design A systematic review and meta-analysis. Setting Not applicable. Patient(s) Undergoing Ovulation Induction IUI. Intervention(s) Any form of exogenous P in Ovulation Induction IUI cycles. Main Outcome Measure(s) Clinical pregnancy and live birth. Result(s) Five trials were identified that met inclusion criteria and comprised 1,298 patients undergoing 1,938 cycles. Clinical pregnancy (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.15–1.98) and live birth (OR 2.11, 95% CI 1.21–3.67) were more likely in P-supplemented patients. These findings persisted in analyses evaluating per IUI cycle, per patient, and first cycle only data. In subgroup analysis, patients receiving gonadotropins for Ovulation Induction had the most increase in clinical pregnancy with P support (OR 1.77, 95% CI 1.20–2.6). Conversely, patients receiving clomiphene citrate (CC) for Ovulation Induction showed no difference in clinical pregnancy with P support (OR 0.89, 95% CI 0.47–1.67). Conclusion(s) Progesterone luteal phase support may be of benefit to patients undergoing Ovulation Induction with gonadotropins in IUI cycles. Progesterone support did not benefit patients undergoing Ovulation Induction with CC, suggesting a potential difference in endogenous luteal phase function depending on the method of Ovulation Induction.
