Clomiphene Citrate as An Adjuvant to hMG Stimulation of the Ovaries in Mid-to-late Follicular Phase

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Objective To compare the results of a novel regimen of human menopausal gonadotrophin (hMG) in combination with clomiphene citrate (CC) in mid-to-late follicular phase with those of a short protocol of GnRH agonist (GnRHa) and hMG used for IVF. Methods In the retrospective study, 842 patients undergoing IVF were collected and classified into two groups: hMG in combination with CC in mid-to-late follicular phase (group A, n=319) and short protocol of GnRHa-hMG (group B, n=523). The main outcome measures were ovarian responses in stimulation cycles and pregnancy outcomes in subsequent frozen-thawed embryo transfer (FET) cycles. Results In group A, the serum LH concentration on day 8-10 was similar with that on the day of hCG administration (2.43 ± 1.92 IU vs 2.51 ± 2.05 IU). The number of mature follicles and oocytes retrieved was significantly lower in group A than in group B while the fertilization rate and the cleavage rate were comparable. The clinical pregnancy rate (47.79% vs 48.04%), the implantation rate (32.49% vs 33.11%) and the cumulative pregnancy rate (58.09% vs 60.22%) were respectively similar in group A and group B. Conclusion hMG in combination with CC in mid-to-late follicular phase results in the same pregnancy outcome as short protocol. The novel protocol may take the advantage of eliminating the occurrence of a premature endogenous LH surge. Objective To compare the results of a novel regimen of human menopausal gonadotrophin (hMG) in combination with clomiphene citrate (CC) in mid-to-late follicular phase with those of a short protocol of GnRH agonist (GnRHa) and hMG used for IVF. Methods In the retrospective study, 842 patients undergoing IVF were collected and classified into two groups: hMG in combination with CC in mid-to-late follicular phase (group A, n = 319) and short protocol of GnRHa-hMG n = 523). The main outcome measures were ovarian responses in stimulation cycles and pregnancy outcomes in subsequent frozen-thawed embryo transfer (FET) cycles. Results In group A, the serum LH concentration on day 8-10 was similar with that on the the day of hCG administration (2.43 ± 1.92 IU vs 2.51 ± 2.05 IU). The number of mature follicles and oocytes retrieved was significantly lower in group A than in group B while the fertilization rate and the cleavage rate were comparable. The clinical pregnancy rate ( 47.79% vs 48. 04%), the implantation rate (32.49% vs 33.11%) and the cumulative pregnancy rate (58.09% vs 60.22%) were both similar in group A and group B. Conclusion hMG in combination with CC in mid-to-late follicular phase results in the same pregnancy outcome as short protocol. The novel protocol may take the advantage of eliminating the occurrence of a premature endogenous LH surge.
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