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대한생식의학회지 제26권 제1호 2010년
Clomiphene Citrate와 성선자극호르몬을 병합한 배란유도주기에서 성교와 인공수정에 의한 임신율의 비교
홍산부인과 불임클리닉
홍정의, 이지삼 ,
Pregnancy Rate by Intrauterine Insemination(IUI) or Timed-Intercourse Combined with Clomiphene Citrate and Gonadotropins
Hong je, Lee js
To evaluate the effectiveness of intrauterine insemination(IUI) in the treatment of infertility, timed-intercourse and intrauterine insemination by husband combined with clomiphene citrate and gonadotropins were compared in a total of 105 cycles. Patients received 100mg of clomiphene citrate daily for 5 days starting on day 3 of the menstrual cycle followed by hMG or FSH. Doses of exogenous gonadotropins were adjusted by the follicular development and concentrations of serum estradiol(E2). More than 3 follicles reaching >16mm were present in the ovary, 5,000 IU of hCG was administered intramusculary. Patients received a maximum of three intercourse or IUI cycles for the treatment. Severe male(< 10 X 106 motile sperm) or age factor(> 39 y) patients were excluded in this study. Pregnancy was classified as clinical if a gestational sac or fetal cardiac activity was seen on ultrasound. The overall clinical pregnancy rates were 17.1% per cycle(18/105) and 21.2% per patient(18/85). The pregnancy rates(per cycle) were 17.5%(11/63) in intercourse and 16.7%(7/42) in IUI groups, respectively. IUI had no significant improvement in pregnancy rate compared with timed-intercourse. The multiple pregnancy rates were 11.1%(1 twin and 1 triplet). No patient developed ovarian hyperstimulation. Abortion rate was 28.6%(2/7) in IUI group only. The delivery and ongoing pregnancy rates were 15.2% per cycle(16/105) and 18.8% per patient(16/85). There were no differences in age, duration of infertility, follicle size and level of estradiol(E2) on the day of hCG injection in pregnant and non-pregnant groups. However, total doses of gonadotropins were higher in pregnant group than in non-pregnant group(P<0.01). Pregnancy rate was not affected by ovulatory status at the time of insemination. These results indicate that well timed-intercourse combined with clomiphene and gonadotropins is as effective as IUI for infertile couples.
키워드 : Infertility, Clomiphene citrate, hMG, FSH, Pregnancy rate, Multiple pregnancy
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