Selection of optimal ovary stimulation protocol for patients with unexplained infertility

Objective To select optimal ovary stimulation protocol for patients with unexplained infertility(UI).MethodsSeventy three patients(101 cycles)with UI were subjected to three ovary stimulation protocols:clomiphene citrate(CC),CC+human menopausal gonadotropin(HMG),or HMG.Trans-vaginal B-ultrasonic scanning combined with urine LH detection and cervical mucus evaluation by Insler scoring system were used to determine appropriate time of HCG injection.Timed intercourse was recommended 30-40 h after HCG administration.The luteal phase was supplemented with progesterone intramuscularly.ResultsThere were no differences in demographic characteristics between groups.The follicular phase was significantly longer in CC group compared with CC+HMG and HMG group[(16.32±1.73)d vs.(15.3±1.49)d and(13.85±1.19)d,respectively].The endometrial thickness at the time of HCG administration was significantly higher in patients receiving CC+HMG[(9.15±0.85)mm]and HMG[(9.52±1.36)mm]when compared with that in CC group[(7.44±0.96)mm],so did with the number of ruptured follicles(2.06±0.75 and 2.48±0.68 vs.1.84±0.86,respectively,P0.05).Pregnancy rates were significantly higher in CC+HMG and HMG group compared with that in CC group(24.24% and 26.92% vs.12.9%,respectively;P0.05),but comparable between CC+HMG and HMG group.The cancellation rate of treatment cycles was highest in HMG group(18.75%).1 OHSS case occurred in CC group,1 in CC+HMG group and 2 in HMG group.Totally 2 twins occurred,both in HMG group.ConclusionsThe combined use of CC+HMG yielded a pregnancy rate higher than CC and comparable with HMG,and a lower cancellation rate and OHSS incidence compared with HMG group.CC+HMG may be regarded as the optimal selection for patients with UI receiving ovary stimulation protocol.