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18. Impact of Ovarian Stimulation Protocols on Intrauterine Insemination Success in Patients with PCOS
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Original Article |
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Impact of Ovarian Stimulation Protocols on Intrauterine Insemination |
Impact of Ovarian Stimulation Protocols on Intrauterine Insemination Success in Patients with PCOS
Sara Gul, Nazia, Sidra Gohar, Kokab Saba, Amina Bibi and Shadab Mumtaz
ABSTRACT
Objective: To assess the efficacy of various protocols of ovarian stimulation in regard to the main IUI parameters in patients with PCOS.
Study Design: A cross sectional study
Place and Duration of Study: This study was conducted at the Department of Obstetrics & Gynecology District head quarter teaching hospital swabi from Jan 2023 to Dec 2023.
Methods: Eighty PCOS patients who were undergoing IUI with different OS protocols containing; Clomiphene citrate, Letrozole and Gonadotropins were involved. These patients were then randomized into one of these protocols and followed for follicular development, endometrial development and timing of intracervical insemination. Outcome measures were defined as clinical pregnancy rates. Quantitative data were summarized and analyzed using standard deviation (SD) and p- test to determine the degree of significance of outcome between the groups.
Results: out of eighty patients, twenty-five took clomiphene citrate; thirty took letrozole, and twenty five gonadotropins. The overall clinical pregnancy rate was significantly higher in the gonadotropin (40%), letrozole (33%) and clomiphene citrate (20%). The endometrial thickness in the gonadotropin group was also greater with endometrial thickness SD 1.5, p < 0.05 indicating that there may exist a direct correlation between the endometrial thickness and the pregnancy rates. Pregnancy rate of letrozole and gonadotropin was significantly higher than clomiphene citrate at p < 0.01 level of significance.
Conclusion: Thus, it revealed that gonadotropins and letrozole are superior to clomiphene citrate when it comes to IUI success in patients with PCOS primarily because of a better quality of the follicle and endometrial lining. Choosing the most suitable OS protocol depends on the patient’s needs that may potentially improve the success rate for IUI in patients with PCOS.
Key Words: Ovarian Stimulation,PCOS, IUI treatment, Clomiphene Citrate,Gonadotropins