2012년 미국불임학회 (ASRM) P-536 How many months are required for recovery after CC+hMG/IUI failure? (과배란 인공수정 실패 시 다음 인공수정 시술까지 회복기간은 얼마나 필요한가?)

Hong-Gil Sun1, K.H. Lee1, I.H. Park1, S.G. Kim1, J.H. Lee1 and Gyun-Ho Jeon2.
1 Mamapapa&baby OB&GY, 1367-5 Hwashin building 4th floor Dal-dong, Nam-gu Ulsan, X, Republic of Korea, 680-805
2 OBGY, Inje University, Haeundae Paik Hospital, Haeundaero 875, Haeundae-gu Busan, X, Republic of Korea, 612-030.

OBJECTIVE

Controlled ovarian hyperstimulation(COH) can alters endometrial development and impair endometrial receptivity. These changes may affect pregnancy rate in next IUI cycle. In general, it is known that more than two menstrual cycles are needed for recovery after COH. But it is not known adequate recovery period in CC+hMG/IUI cycle. The aim of this study is to evaluate whether recovery period after CC+hMG/IUI failure may affect pregnancy rate in next cycle.

DESIGN

A retrospective study

MATERIALS AND METHODS

The study included 801 patients from January 2010 to October 2011. Clomiphene citrate (100mg/day) was given to patients on days 3-7. Patients were treated with hMG 150 IU on day 8, 10. When the sufficient follicular size and endometrial thickness had been reached, hCG was administrated and insemination was performed. We divided the patients of pregnancy failure into three groups. In group A, inseminations were performed in the following menstrual cycle (385 patients), in group B, after one resting menstrual cycle (119 patients), in group C, after two or more resting menstrual cycles (118 patients).

RESULTS

The study population consisted of 801 patients with average age of 33.5±3.3. We excluded 150 women with successful pregnancy in first attempt (pregnancy rate : 22.60%, 150/801) and 29 women with follow-up loss. Pregnancy rates were 11.17% (43/385) in group A, 10.08% (12/119) in group B and 22.03% (26/118) in group C. Group C and first attempt had significantly higher pregnancy rate than group A and B (P<0.05). Pregnancy rate in group C was similar to that of first attempt insemination (22.03% vs. 22.60%).

CONCLUSION

In cases of none or one resting cycle after failure in CC+hMG/IUI, decreased pregnancy rate was observed probably due to impaired endometrial receptivity. Two or more resting menstrual cycles made similar pregnancy rate to first attempt. In CC+hMG/IUI cycle, we conclude that recovery period may enhance pregnancy rate and a preferred duration is suggested to two or more menstrual cycles.