Management of ovulation induction and intrauterine insemination in infertile patients with hypogonadotropic hypogonadism

dc.authorid0000-0001-9442-2690
dc.contributor.authorKıyak, Hüseyin
dc.contributor.authorBulut, Berk
dc.contributor.authorKaracan, Tolga
dc.contributor.authorÖzyürek, Eser
dc.contributor.authorGedikbaşı, Ali
dc.contributor.authorApi, Murat
dc.date.accessioned2020-01-08T08:32:32Z
dc.date.available2020-01-08T08:32:32Z
dc.date.issued2019
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Kadın Hastalıkları ve Doğum Ana Bilim Dalı
dc.description.abstractAim: To investigate the effectiveness of ovulation induction and intrauterine insemination (OI + IUI) in female patients with hypogonadotropic hypogonadism (HH), and to compare the outcomes of different stimulation protocols and cycle characteristics. Material and methods: The outcomes of OI + IUI treatments in patients with HH diagnosed between 2010 and 2018 were retrospectively evaluated. Cycles using recombinant (rec) luteinizing hormone (LH) or human menopausal gonadotropin (hMG) as LH sources were compared with each other. The cycle characteristics and pregnancy rates of the first cycles were compared with those of the second cycles in patients who underwent 2 or more cycles. Results: Of 104 patients diagnosed with World Health Organization type 1 anovulation, 99 were treated with hMG or rec LH + rec follicle-stimulating hormone (FSH) in a total of 220 cycles. The mean age of the study patients was 27.8 +/- 4.6 years (range, 19-39 years). Rec FSH + rec LH was given in 37 cycles, and hMG was used in 183 cycles. The hormone values were as follows: FSH, 1.4 +/- 1.6 mIU/mL; LH, 0.7 +/- 1.2 mIU/mL; oestradiol, 13 (15.8 +/- 12.0) pg/mL; and anti-Mullerian hormone, 2.1 (2.6 +/- 1.2) ng/mL. A dominant follicle was observed in 85.7% of the first cycles and in 86.2% of the second cycles. The treatment lasted 17.2 +/- 5.0 and 15.5 +/- 3.8 days until the human chorionic gonadotropin (hCG) administration day in the first and second cycles, respectively, and the difference was statistically significant (p < 0.05). The cycle cancellation rate was 8.1% (n = 3) in cycles done using rec gonadotropins and 29% (n = 53) in patients stimulated with hMG, and the difference was statistically significant (p < 0.05). The pregnancy rates were 12.7% and 28.3% per cycle and per patient, respectively. The pregnancy rate in hCG-triggered patients (successful stimulation) was 17.1% per cycle in all patients. Conclusion: OI with gonadotropins and IUI is a safe, efficient, and relatively cost-effective treatment option in patients with HH, yielding reasonable pregnancy rates per cycle and per patient. The use of rec FSH + rec LH facilitates cycle management but does not positively contribute to pregnancy rates and is more expensive than some other feasible options. (C) 2019 Elsevier Masson SAS. All rights reserved.
dc.identifier.citationKıyak, H., Bulut, B., Karacan, T., Özyürek, E., Gedikbaşı, A. ve Api, M. (2019). Management of ovulation induction and intrauterine insemination in infertile patients with hypogonadotropic hypogonadism. Journal of Gynecology Obstetrics and Human Reproduction, 48(10), 833-838. https://doi.org/10.1016/j.jogoh.2019.03.027
dc.identifier.doi10.1016/j.jogoh.2019.03.027
dc.identifier.endpage838
dc.identifier.issn2468-7847
dc.identifier.issn1773-0430
dc.identifier.issue10
dc.identifier.scopusqualityQ3
dc.identifier.startpage833
dc.identifier.urihttps://doi.org/10.1016/j.jogoh.2019.03.027
dc.identifier.urihttps://hdl.handle.net/20.500.12511/4894
dc.identifier.volume48
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherElsevier
dc.relation.ispartofJournal of Gynecology Obstetrics and Human Reproductionen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectHypogonadotropic Hypogonadism
dc.subjectIntrauterine İnsemination
dc.subjectPregnancy Rate
dc.subjectGonadotropin Stimulation
dc.titleManagement of ovulation induction and intrauterine insemination in infertile patients with hypogonadotropic hypogonadism
dc.typeArticle

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