Abstract
A combination of clomiphene citrate and human menopausal gonadotropin was employed for enhanced follicular recruitment in an in vitro fertilization program. All patients received 50 mg of clomiphene and 1 ampule of human menopausal gonadotropin daily from cycle day 5 through cycle day 9. Follicular monitoring was begun on day 10 using a combination of ultrasound measurement of follicular size and number and determination of peripheral estradiol levels. Based on the size and number of follicles, the peirpheral levels of estradiol, and the rate of follicular growth and increase in estradiol, human menopausal gonadotropin was continued at a dosage of 1 to 3 ampules/day through the day of human chorionic gonadotropin administration. Human chorionic gonadotropin was administered on the evening of the day the largest follicle reached or exceeded 20 mm in mean diameter if the estradiol levels had been rapidly rising or reaching a plateau and had exceeded a minimal level of 300 pg/ml. Using this protocol, 30 of 33 patients underwent laparoscopy, 29 patients had successful oocyte recovery, and 23 patients underwent embryo replacement, with the establishment of six clinical pregnancies.
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Feichtinger W, Kemeter P, Szalay S: The Vienna program of in vitro fertilization and embryo transfer: A successful clinical treatment. Eur J Obstet Gynecol Reprod Biol 1983;15:63–70
Kerin JF, Warnes GM, Quinn PJ, Jeffrey R, Kirby C, Matthews CD, Seamark RF, Cox LW: Incidence of multiple pregnancy following human in vitro fertilization and embryo transfer. Lancet 1983;2:537–540.
Jones HW Jr: Factors influencing implantation and maintenance of pregnancy following embryo transfer.In Fertilization of the Human Egg in Vitro, HM Beier, HR Lindner (eds.) Berlin, Springer-Verlag, 1983, pp 293–306
Byrd WF, Wolf DP: Oogenesis, fertilization and early development.In Human in Vitro Fertilization and Embryo Transfer, DP Wolf, MM Quigley (eds). New York, Plenum Press, 1984, pp 213–274
Quigley MM, Maklad NF, Wolf DP: Comparison of two clomiphene citrate dosage regimens for follicular recruitment in an in vitro fertilization program. Fertil Steril 1983;40:178–182
Trounson AO, Leeton JF: The endocrinology of clomiphene stimulation.In Human Conception in Vitro, RG Edwards, JM Purdy (eds). London, Academic Press, 1982, pp 51–55
Vargyas JM, Siato H, Gibbons WE, Suelo C, Yee W, Marrs RP: Effect of different methods of ovarian stimulation on the human in vitro fertilization and embryo transfer procedure. Fertil Steril 1983;39:438
Quigley MM, Schmidt CL, Beauchamp PJ, Pace-Owens S, Berkowitz AS, Wolf DP: Human menopausal gonadotropin compared to clomiphene citrate for enhanced follicular recruitment in an in vitro fertilization program (submitted for publication)
Laufer N, DeCherney AH, Haseltine FP, Polan ML, Mezer HC, Dlugi AM, Sweeny D, Nero F, Naftolin F: The use of high-dose human menopausal gonadotropin in an in vitro fertilization program. Fertil Steril 1983;40:734–741
Quigley MM, Schmidt CL, Beauchamp PJ, Pace-Owens S, Berkowitz AS, Wolf DP: Enhanced follicular recruitment in an in vitro fertilization program: Clomiphene alone versus a clomiphene-human menopausal gonadotropin combination. Fertil Steril 1984;42:25–33
Mandelbaum J, Plachot M, Cohen J, Junca A-M, Debache C: The use of Clomid and bMG in human in vitro fertilization: Consequences for egg quality and luteal phase adequacy.In Fertilization of the Human Egg in Vitro, HM Beier, HR Lindner (eds), Berlin, Springer-Verlag, 1983, pp 123–130
Lopata A: Concepts in human in vitro fertilization and embryo transfer. Fertil Steril 1983;40:289–301
Edwards RG, Steptoe PC, Purdy JM: Establishing full-term human pregnancies using cleaving embryos grown in vitro. Brit J Obstet Gynaecol 1980;87:737–756
Maklad NF: Monitoring follicular development with ultrasound.In Human in Vitro Fertilizaton and Embryo Transfer, DP Wolf, MM Quigley (eds). New York, Plenum Press, 1984, pp 119–132
Purdy JM: Methods for fertilization and embryo culture in vitro.In Human Conceptions in Vitro, RG Edwards, JM Purdy (eds). London, Academic Press, 1982, pp 135–148
Sokoloski JE, Wolf DP: Laboratory details of an in vitro fertilization and embryo transfer program.In Human in Vitro Fertilization and Embryo Transfer, DP Wolf, MM Quigley (eds). New York, Plenum Press, 1984, pp 275–296
Quigley MM: The use of ovulation inducing agents for enhanced follicular recruitment for in vitro fertilization. Clin Obstet Gynecol 1984 (in press)
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Quigley, M.M., Schmidt, C.L., Beauchamp, P.J. et al. Preliminary experince with a combination of clomiphene and variable dosages of menopausal gonadotropins for enhanced follicular recruitment. J Assist Reprod Genet 2, 11–16 (1985). https://doi.org/10.1007/BF01130826
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DOI: https://doi.org/10.1007/BF01130826