What is the optimal follicular size before triggering ovulation in intrauterine insemination cycles with clomiphene citrate or letrozole? An analysis of 988 cycles

Palatnik, Anna; Strawn, Estil; Szabó, Anikó; Robb, Paul

doi:10.1016/j.fertnstert.2012.02.018

Cited by 37 publications

(22 citation statements)

References 24 publications

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“…Even in IUI cycles, where ovulation suppression is not used, there may be a pregnancy benefit to delaying the LH surge. A recent publication has demonstrated that the optimal follicle size on ultrasound to achieve pregnancy in clomiphene citrate or letrozole cycles is 2.5 cm rather than 1.8 cm [19]. Nimodipine is a relatively lipophillic calcium channel blocker that crosses the blood brain barrier to exert its effects intracerebrally [11].…”

Section: Discussionmentioning

confidence: 99%

Nimodipine, a calcium channel blocker, delays the spontaneous LH surge in women with regular menstrual cycles: a prospective pilot study

Nayot

Klachook

Casper

2013

Reprod Biol Endocrinol

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BackgroundCurrently GnRH analogue injections are used to prevent premature LH surges in women undergoing assisted reproductive technology. This was a pilot study to determine the safety and effectiveness of nimodipine, an oral calcium channel blocker, to delay the mid-cycle spontaneous LH surge in women with regular menstrual cycles.MethodsEight women with regular menstrual cycles self-monitored three consecutive cycles for the day of an LH surge by daily urine assay. The first and third cycles were observatory. In the second cycle, subjects took nimodipine 60 mg by mouth three times daily for four days, starting two days prior to the expected LH surge day based on cycle one.ResultsThe LH surge day in cycle 2 (nimodipine) was significantly delayed in comparison to both observatory cycle 1 (15.5+/−3.4 vs 14.0+/−2.8 days; p = 0.033) and cycle 3 (15.1+/−3.5 vs 13.1+/−2.4 days; p = 0.044). There was no difference in the LH surge day between the two observatory cycles (13.4+/−2.4 vs 13.1+/−2.4 days; p = 0.457). Three patients experienced a mild headache.ConclusionsThere was a statistically significant delay in the spontaneous LH surge day in the treatment cycle in comparison to both observatory cycles. Nimopidine should be further investigated as an oral alternative to delay a spontaneous LH surge.

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Section: Discussionmentioning

confidence: 99%

Nimodipine, a calcium channel blocker, delays the spontaneous LH surge in women with regular menstrual cycles: a prospective pilot study

Nayot

Klachook

Casper

2013

Reprod Biol Endocrinol

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“…The optimal follicular size before triggering ovulation in intrauterine insemination cycles with clomiphene citrate or letrozole was found to be in the 23-28 mm range. The optimal size of the leading follicle was not statistically signifi cantly different between cycles using letrozole or clomiphene citrate and was closely related to the endometrial thickness [ 5 ]. Intrafollicular echoes may be observed with mature follicles, probably arising from clusters of granulosa cells that shear off the wall near the time of ovulation.…”

Section: Follicular Selection: Morphological and Ultrasound Observationsmentioning

confidence: 92%

“…Ovulation will occur 34-36 h following hCG injection, so the IUI is often performed 34 h later. Recently Paltnik et al [ 5 ] have shown that higher pregnancy rates were achieved when the leading follicle was in the 23-28 mm range. Universal agreement is lacking as to when to introduce ultrasonographic cycle monitoring versus less complicated or costly alternatives.…”

Section: Treatment Schema and Monitoring Of Clomiphene Citrate Therapymentioning

confidence: 99%

Ultrasound in Follicle Monitoring for Ovulation Induction/IUI

Blankstein

Malepati

Brasch

2013

Ultrasound Imaging in Reproductive Medicine

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“…In this study, 800 infertile women were treated with clomiphene or letrozole. They reported follicular size 24 mm and endometrial thickness 9 mm in IUI cycles are effective for treatment [10]. Several studies is done to examine the optimal size and number of dominant follicles and timing of gonadotropin injection in IUI cycles.…”

Section: Success Rate Of Iui Was Influenced By Different Factorsmentioning

confidence: 99%

“…Several studies is done to examine the optimal size and number of dominant follicles and timing of gonadotropin injection in IUI cycles. All of these studies have controversies regarding on the appropriate size of the follicles and gonadotropin injection time [10,11]. The aim of our study was to evaluate the appropriate and optimal size of follicles before HCG injection in COH-IUI cycles and comparison of pregnancy rate in patients with different follicle size.…”

Section: Success Rate Of Iui Was Influenced By Different Factorsmentioning

confidence: 99%

Evaluation of the Appropriate Size of Follicles on Success Rate in Patient Undergoing Controlled Ovarian Stimulation and Intrauterine Insemination Cycles

Tafti

Yasaei

Dehghani-Firouzabadi

et al. 2017

Journal of Advanced Medical Sciences and Applied Technologies

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Objectives: Intra-Uterine Insemination (IUI) is one of the methods for infertility treatments. The size of the follicles and endometrial thickness are two important factors in pregnancy rate of patients undergoing controlled ovarian stimulation and intrauterine insemination cycles (COH-IUI). The aim of this study was to investigate the success rate of IUI and follicular size and other associated factors in infertile couples. Materials & Methods:The study group was the patients who were undergoing COH-IUI. BMI of all women recorded and ovulation induction was propelled and when there was appropriate endometrial thickness and at least one dominant follicle in trans-vaginal ultrasonography. 36 hours after HCG injection, IUI was performed. Then pregnancy rate between patients who had follicle size fewer than 20 mm and higher than 20 mm was assumed.Results: 159 cases of IUI were performed and pregnancy happened in 22(14.1 %). In nonpregnant group (134 cases), 78 cases had under 20 mm follicles and 47 cases had higher than 20 mm follicles. In pregnant group (22 cases) 10 cases had fewer than 20 mm follicles and 12 cases had higher than 20 mm follicles in the time of HCG injection. Endometrial thickness was 8.01±1.42 mm in patients with follicles more than 20 mm. Conclusion:The success rate in controlled ovarian stimulation and intrauterine insemination cycles closely related to obtaining of optimal size of follicles and endometrial thickness.

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What is the optimal follicular size before triggering ovulation in intrauterine insemination cycles with clomiphene citrate or letrozole? An analysis of 988 cycles

Cited by 37 publications

References 24 publications

Nimodipine, a calcium channel blocker, delays the spontaneous LH surge in women with regular menstrual cycles: a prospective pilot study

Nimodipine, a calcium channel blocker, delays the spontaneous LH surge in women with regular menstrual cycles: a prospective pilot study

Ultrasound in Follicle Monitoring for Ovulation Induction/IUI

Evaluation of the Appropriate Size of Follicles on Success Rate in Patient Undergoing Controlled Ovarian Stimulation and Intrauterine Insemination Cycles

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