CUMULATIVE CONCEPTION AND LIVE BIRTH-RATES AFTER THE TREATMENT OF ANOVULATORY INFERTILITY - SAFETY AND EFFICACY OF OVULATION INDUCTION IN 200 PATIENTS

In analysis was performed on the cumulative conception rates, cumulati ve live birth rates and adverse effects of ovulation induction in pati ents with anovulatory infertility attending a single unit over an Ii-y ear period. A total of 200 patients were included, 103 with clomiphene -resistant polycystic ovary syndrome (PCOS), 77 with hypogonadotrophic hypogonadism (HH) and 20 with weight-related amenorrhoea (WRA). Ovula tion induction was performed using a number of protocols in which puls atile luteinizing hormone-releasing hormone was administered s.c. or i .v. and gonadotrophins (human menopausal gonadotrophins or follicle-st imulating hormone) were administered i.m. The cumulative conception an d live birth rates in the first course of therapy and after 12 cycles of treatment were, respectively, 73.2 and 62.4% in PCOS patients, 82.1 and 65.4% in the KH group and 95.0 and 85.3% in the WRA group. The mi scarriage rates for all courses of treatment were 15.5% in PCOS patien ts, 22.9% in HH patients and 32.3% in WRA patients which resulted in c umulative live birth rates that were not significantly different. The median number of cycles and ovulations to achieve a pregnancy was 2 in all groups. The multiple pregnancy rate was significantly greater in women with PCOS (17.9%) than in women with HH (3.6%, P = 0.0052, 95% C I 5.12-23.36%) but not WRA (3.2%, P = 0.07, 95% CI 4.35-24.92%). The r ate of multiple pregnancy fell after the introduction of monitoring by transvaginal ultrasound. Correction of anovulatory infertility by app ropriately selected ovulation induction regimens results in cumulative conception and live birth rates indistinguishable from normal.