Açıklanamayan İnfertilitede IUI Tedavisinde GND ve Klomifen Sitrat İle Ovulasyon İndüksiyonu İle Gelişen Preovulatuar Folikül Sayısının Gebelik Oranlarına Etkisi

Abstract

Aim: The aim of this study is to investigate whether the number of dominant follicles formed in IUI with ovarian stimulation (OS) affects pregnancy outcomes in couples with unexplained infertility. Material and Method: 217 couples aged 24-39 years with unexplained infertility and treated with IUI by way of OS participated in our study. The patients were divided into 2 groups of which the first included the clinically pregnant and the second did not, and were compared in terms of age, monofollicle and bifollicle development, infertility duration, treatment initiation day, hcg day, leading follicle diameter, endometrial thickness, number of dominant follicles and treatment type. Results: Of the 217 patients who underwent IUI for unexplained infertility, no significant difference was found between the groups with and without clinical pregnancy in terms of the number of dominant follicles (p=0.73). There was a positive but low correlation between endometrial thickness and treatment success (Spearman's correlation coefficient value = 0.14, p=0.03). The receiver operating characteristic curve analysis revealed that the optimal cut-off value for endometrial thickness to predict pregnancy success was 9.5 mm (55.0% sensitivity, 65.0% specificity). Conclusions: As a result, we suggest that gonadotropins are not superior to oral agents in terms of clinical pregnancy rates in unexplained infertility, therefore treatment should commence with less invasive and less costly oral agents. Furthermore, we think that the number of dominant follicles (monofollicles or bifollicles) created by ovarian stimulation does not affect clinical pregnancy success, but endometrial thickness is closely related to pregnancy rates and deserves attention.