在一项多中心试验中，卵泡期长度与接受卵巢刺激和宫腔内人工授精周期的不明原因不孕妇女的活产结果无关

FS Reports Pub Date : 2023-12-01 DOI:10.1016/j.xfre.2023.08.003

Pardis Hosseinzadeh M.D. , Jennifer D. Peck Ph.D. , Heather R. Burks M.D. , Irene Souter M.D. , Angela Xing B.S. , LaTasha B. Craig M.D. , Michael P. Diamond M.D. , Karl R. Hansen M.D. Ph.D.

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引用次数: 0

摘要

目的评估卵泡期长度（FPL）对接受枸橼酸氯米芬、来曲唑或促性腺激素卵巢刺激宫腔内人工授精（OS-IUI）的不明原因不孕妇女的妊娠结局和子宫内膜厚度（ET）的影响。干预措施FPL作为分类变量进行评估，按五分位数定义（q1：≤11天，q2：12天，q3：13天，q4：14-15天，q5：≥16天）。主要结局指标：临床妊娠率、活产率和ET.结果：在所有治疗组合并的未调整或调整模型中，或按卵巢刺激药物分层时，降低FPL五分位数不会降低临床妊娠率或活产率。在接受枸橼酸克罗米芬或来曲唑治疗的妇女中，与第 5 个五分位数（≥16 天）相比，所有 FPL 类别的 ET 都明显较薄。在使用促性腺激素进行卵巢刺激的妇女中也观察到了类似的关联性，但这种关联性有所减弱，但与FPL≥16天的妇女相比，观察到的差异仅限于FPL为12天或更短的妇女。如果按治疗方法对临床妊娠率和活产率进行分层分析，也会发现类似的情况。

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Follicular phase length is not related to live birth outcome in women with unexplained infertility undergoing ovarian stimulation with intrauterine insemination cycles in a multicenter trial

Objective

To evaluate the effect of follicular phase length (FPL) on pregnancy outcomes and endometrial thickness (ET) among women with unexplained infertility undergoing ovarian stimulation with intrauterine insemination (OS-IUI) with clomiphene citrate, letrozole, or gonadotropins.

Design

Cohort analysis of the Reproductive Medicine Network's Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation randomized controlled trial.

Setting

Multicenter randomized controlled trial.

Patient(s)

A total of 869 couples with unexplained infertility who underwent OS-IUI treatment cycles as part of the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation study.

Intervention(s)

FPL was evaluated as a categorical variable defined by quintiles (q1: ≤11 days, q2: 12 days, q3: 13 days, q4: 14–15 days, and q5: ≥16 days).

Main outcome measure(s)

Clinical pregnancy, live birth rates, and ET.

Result(s)

Decreasing FPL quintiles did not reduce clinical pregnancy or live birth rates in unadjusted or adjusted models with all treatment groups combined or when stratified by the ovarian stimulation medication. All FPL categories had significantly thinner ET compared with the 5th quintile (≥16 days) among women treated with clomiphene citrate or letrozole. Similar but diminished associations were observed among women who underwent ovarian stimulation with gonadotropins, but the observed differences were limited to those with FPL of 12 days or shorter when compared with FPL ≥16 days.

Conclusion(s)

Although shorter FPL was associated with reduced ET, it was not associated with the outcomes of clinical pregnancy or live birth in women with unexplained infertility undergoing OS-IUI in all treatment groups combined. Similar patterns existed when analyses of clinical pregnancy and live birth rates were stratified by treatment.