A randomized study comparing IVF in the unstimulated cycle with IVF following clomiphene citrate

Ingerslev, Hans Jakob; Højgaard, Astrid Ditte; Hindkjær, Johnny; Kesmodel, Ulrik Schiøler

doi:10.1093/humrep/16.4.696

Cited by 65 publications

(35 citation statements)

References 28 publications

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“…In contrast to the natural cycle IVF, where patients are aware that development of only one follicle is expected, the aim of our programme was to obtain at least two or three oocytes. With a single follicle, a higher possibility of non-retrieval or fertilization failure exists (Lashen et al, 1999;Ingerslev et al, 2001). We decided not to subject our financially constrained couples to the disappointment of a post-retrieval failure with its attendant cost implications.…”

Section: Discussionmentioning

confidence: 99%

Affordable ART: a different perspective

et al. 2011

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background: Although 10% of the population is affected by infertility, the treatment option of in-vitro fertilisation (IVF) remains unaffordable for the majority of infertile couples. We have initiated a low cost programme incorporating an uncommonly used, but recognized, ovarian stimulation protocol, together with certain cost limiting initiatives in an established assisted reproductive technology (ART) set up. methods:The medical records of women who underwent the low cost programme were analysed. Clomiphene citrate 50 mg daily was administered from Day 2 of the cycle and continued till the day of hCG trigger, thus preventing the LH surge. Intermittent doses of human menopausal gonadotrophin 150 IU were administered on alternate days from the 5th day onwards. Oocyte retrieval was carried out once at least two follicles of .18 mm were identified. The cycle was monitored by ultrasound only, with embryo transfer being carried out on Day 3. Clinical outcomes were recorded together with an estimation of the direct costs per cycle. Direct cost calculations did not include professional charges or facility costs.results: Of 143 women evaluated, 104 women underwent embryo transfer. The live birth rate and clinical pregnancy rate per embryo transfer were 19 and 22%. The live birth rate per initiated cycle was 14% (20/143). The multiple pregnancy rate was 26% with no case of ovarian hyperstimulation syndrome being recorded. The average direct cost per cycle was US$ 675 for IVF and US$ 725 for an ICSI treatment cycle.conclusions: Using this protocol, together with several cost cutting measures, we achieved an acceptable live birth rate per transfer of 19% at a reasonable cost. This approach could be used by established ART centres to provide treatment to couples who cannot afford conventional ART.

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Section: Discussionmentioning

confidence: 99%

Affordable ART: a different perspective

et al. 2011

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“…Oocyte handling and ICSI procedure was performed as previously described [22]. During the study period, two embryos were transferred routinely.…”

Section: Laboratory Proceduresmentioning

confidence: 99%

Pregnancy prediction models and eSET criteria for IVF patients–do we need more information?

Ottosen

Kesmodel

Hindkjær

et al. 2006

J Assist Reprod Genet

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Purpose: The purpose of the present study was to evaluate statistical prediction models and simple allocation criteria, based on predictors for pregnancy, as tools to identify a good prognosis group in a possible eSET setting.Methods: A pregnancy prediction model based on logistic regression models was generated by analysis of 1675 DET treatment cycles. The model was evaluated and compared to simple eSET allocation criteria.Results: Embryo quality, patient age, and basal FSH were identified as significant predictors (at 5% significance level) of pregnancy. Although comparable to previously generated models, the predictive ability of the present model was relatively poor and practically similar to simple allocation criteria based on age and embryo quality.Conclusions: Existing prediction models, or simple allocation criteria, are limited in identifying good prognosis patients. Future studies of the applicability of improved pregnancy prediction models will need very comprehensive and detailed patient and embryo information.

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“…Different stimulation protocols have been described, including minimal, modified natural, friendly IVF, mini-IVF, and mild stimulation (5,(20)(21)(22)(23). This array of terminologies and protocols led to the formation of ISMAAR-the International Society for Mild Approaches in Assisted Reproduction-which has the goal of developing a universally accepted definition of mild stimulation for clinical practice and research publications (8).…”

Section: Discussionmentioning

confidence: 99%