Sanne C Braam1, Jan Peter de Bruin2, Erato T I A Buisman2, Monique Brandes3, Willianne L D M Nelen3, Jesper M J Smeenk4, Jan Willem van der Steeg2, Ben Willem J Mol5, Carl J C M Hamilton2. 1. Department of Obstetrics and Gynaecology, Academic Medical Center, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: s.c.braam@amc.uva.nl. 2. Department of Obstetrics and Gynaecology, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands. 3. Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. 4. Department of Obstetrics and Gynaecology, St Elisabeth Hospital, Tilburg, The Netherlands. 5. School of Paediatrics and Reproductive Health, University of Adelaide, 5000, SA, Australia.
Abstract
OBJECTIVE: To assess the live birth rate in women with WHO II anovulation and the proportion of women that need second or third line treatments if the initial therapy fails. STUDY DESIGN: In this multicenter cohort study we included couples with unfulfilled child wish who were referred to three fertility clinics in the Netherlands and selected women with a WHO II ovulation disorder as the only final infertility diagnosis (n = 468). RESULTS: The cumulative live birth rate of the total group was 82% (383/468). The majority started with clomiphene-citrate as first-line treatment (n = 378) resulting in 180 (48%) live births. There were 153 couples (40%) who underwent a second-line treatment (recombinant-FSH or laparoscopic electrocoagulation of the ovaries, LEO) and 52 couples (14%) a third-line treatment (IVF/ICSI), resulting in 44% and 63% treatment dependent live births rates, respectively. Of all couples, 92 (20%) conceived naturally, 186 (40%) after clomiphene-citrate, 60 (13%) after recombinant-FSH, nine (2%) after LEO and 36 (8%) after IVF. CONCLUSION: Subfertile women with a WHO II ovulation disorder have a good prognosis on live birth, and most did so after ovulation induction with clomiphene-citrate. If first-line ovulation induction has failed ovulation induction with gonadotrophins or IVF still result in a live birth in about half of the cases.
OBJECTIVE: To assess the live birth rate in women with WHO II anovulation and the proportion of women that need second or third line treatments if the initial therapy fails. STUDY DESIGN: In this multicenter cohort study we included couples with unfulfilled child wish who were referred to three fertility clinics in the Netherlands and selected women with a WHO II ovulation disorder as the only final infertility diagnosis (n = 468). RESULTS: The cumulative live birth rate of the total group was 82% (383/468). The majority started with clomiphene-citrate as first-line treatment (n = 378) resulting in 180 (48%) live births. There were 153 couples (40%) who underwent a second-line treatment (recombinant-FSH or laparoscopic electrocoagulation of the ovaries, LEO) and 52 couples (14%) a third-line treatment (IVF/ICSI), resulting in 44% and 63% treatment dependent live births rates, respectively. Of all couples, 92 (20%) conceived naturally, 186 (40%) after clomiphene-citrate, 60 (13%) after recombinant-FSH, nine (2%) after LEO and 36 (8%) after IVF. CONCLUSION: Subfertile women with a WHO II ovulation disorder have a good prognosis on live birth, and most did so after ovulation induction with clomiphene-citrate. If first-line ovulation induction has failed ovulation induction with gonadotrophins or IVF still result in a live birth in about half of the cases.
Authors: Su Jen Chua; Ben W Mol; Salvatore Longobardi; Raoul Orvieto; Christos A Venetis; Monica Lispi; Ashleigh Storr; Thomas D'Hooghe Journal: Reprod Biol Endocrinol Date: 2021-04-02 Impact factor: 5.211