Minimal stimulation IVF using clomiphene citrate and oral contraceptive pill pretreatment for LH suppression

Objective: To determine if oral contraceptive pill (OC) pre-treatment prior to minimal stimulation IVF using clomiphene citrate (CC) would make the pr ocedure easier to perform by preventing the LH surge and result in pregnanc y rates (PRs) comparable to stimulated IVF. Design: Prospective cohort study. Setting: Private tertiary infertility center. Patient(s): Thirty-two women with tubal or pelvic adhesive disease as the c ause of their infertility, ovulatory cycles, under the age of 40, and no ma le factor. Intervention(s): Two-month ovarian-hypothalamic-pituitary axis s uppression with OC followed by CC 100 mg on day 3 of the cycle for 8 days, hCG administration midcycle, follicle aspiration, NF, and embryo transfer. Main Outcome Measure(s): Oocytes retrieved, serum LH and estradiol levels, maturity of oocytes, fertilization rates, embryo number and quality, and PR s. Result(s): Thirty-six patients completed 71 stimulation cycles and 64 folli cle aspirations. No LH surges occurred with a mean mature oocytes retrieved of 3.2, 90% fertilization rate, and mean 2.5 embryos transferred. Twenty-o ne of the 64 cycles resulted in a clinical pregnancy (32.8% PR per retrieva l) with 2 other biochemical pregnancies and 3 twin gestations. This was not significantly different from the matched cohort stimulated IVF. Conclusion(s): Minimal stimulation IVF is a simple, low-cost, and low-risk alternative to stimulated IVF with comparable PRs. (C) 2000 by American Soc iety for Reproductive Medicine.