A MINIMAL STIMULATION PROTOCOL WITH SIMPLIFIED MONITORING FOR SUPEROVULATION AND INTRAUTERINE INSEMINATION

Objectives: To evaluate the efficacy and cost of a simplified superovulation regimen in infertile patients undergoing
intrauterine insemination (lUI).
Design: Analysis of 170 minimal stimulation and 150 conventional HMO cycles.
Setting: Infertility Clinic. Shatby Hospital for Women, Alexandria.
Patients: 180 women with either unexplained infertility or ovulatory dysfunction who ovulated with clomiphene citrate
but failed to conceive.
Intervention : 90 patients underwent lUI using a simplified superovulation regimen that included clomiphene citrate
100 mg on cycle days 3 through 7 and HMO 75 IU on cycle days 5, 7, 9 and II. A control group (n:::90) received the
standard HMO protocol. In both groups many patients received more than one treatment cycle.
Main outcome measures: Clinical pregnancy rate, medication and monitoring costs.
Results : There was no difference in the couples of the two stimulation protocols regarding age, duration and type of
infertility, as well as, cause of infertility. The monitoring costs and total ampoules of HMO required differed
significantly (4.0 ampoules for minimal stimulation versus 14 ± 3.2 in the conventional HMO). The clinical pregnancy
rates per cycle were comparable (7.78% for minimal stimulation versus 11.11% for HMO). No patients were admitted
for ovarian hyperstimulation.
Conclusion : Minimal stimulation for lUI is less expensive than conventional HMO stimulation and minimizes
monitoring and patient discomfort. The comparable pregnancy rates and decreased medication costs of minimal
stimulation justifies further evaluation of its role in the treatment of infertility.