We aimed to determine the impact of metabolic syndrome （MetS） on reproductive function in men with secondary infertility, a condition that has received relatively little attention from researchers. Complete demograp...We aimed to determine the impact of metabolic syndrome （MetS） on reproductive function in men with secondary infertility, a condition that has received relatively little attention from researchers. Complete demographic, clinical, and laboratory data from 167 consecutive secondary infertile men were analyzed. Health-significant comorbidities were scored with the Charlson Comorbidity Index （CCI; categorised 0 vs I vs 2 or higher）. NCEP-ATP III criteria were used to define MetS. Semen analysis values were assessed based on the 2010 World Health Organization （WHO） reference criteria. Descriptive statistics and logistic regression models tested the association between semen parameters and clinical characteristics and MetS. MetS was found in 20 （12%） of 167 men. Patients with MetS were older （P 〈 0.001） and had a greater BMI （P 〈 0.001） compared with those without MetS. MetS patients had lower levels of total testosterone （P = 0.001）, sex hormone-binding globulin, inhibin B, and anti-MOIlerian hormone （all P 〈 0.03）, and they were hypogonadal at a higher prevalence （P = 0.01） than patients without MetS. Moreover, MetS patients presented lower values of semen volume, sperm concentration, and sperm normal morphology （all P≤0.03）. At multivariate logistic regression analysis, no parameters predicted sperm concentration, normal sperm morphology, and total progressive motility. Our data show that almost 1 of 8 White-European men presenting for secondary couple＇s infertility is diagnosed with MetS. MetS was found to be associated with a higher prevalence of hypogonadism, decreased semen volume, decreased sperm concentration, and normal morphology in a specific cohort of White-European men.展开更多
Semen samples collected from 28 male partners of infertile couples were divided into three equal aliquots and prepared with three selected media,such as PureSperm （Nidacon,Gothenburg,Sweden）,Sil-Select Plus^TM （Fer...Semen samples collected from 28 male partners of infertile couples were divided into three equal aliquots and prepared with three selected media,such as PureSperm （Nidacon,Gothenburg,Sweden）,Sil-Select Plus^TM （Fertipro,Beemem,Belgium） and SpermGrad^TM（Vitrolife,Gothenburg,Sweden）. The differences in mean percentages of semen parameters were assessed by repeated measures analysis. Correlations of sperm DNA damage,as measured by terminal deoxynucleotidyl transferase dUTP nick end labeling （TUNEL） assay,and of protamine deficiency,as measured by chromomycin A3 （CMA3） staining with sperm parameters,were determined by Pearson＇s correlation. After preparation with all three media,sperm concentrations decreased （P〈0.05） while percentages of sperm with normal morphology increased （P〈0.05）. Percentages of sperm motility,rapid motility and progressive motile concentration （PMC） increased （P〈0.05） for each ofthese parameters,PureSperm preparation gave the best results （P〈0.05）. The percentage of DNA damage decreased in the PureSperm and Sil-Select Plus preparations （17.9% and 31.3%,respectively,P〈0.05） and increased in the SpermGrad preparation （56.3%,P〈0.05）. Protamine deficiency also decreased in all three kinds of media,59.3%,47.7% and 40.3% for PureSperm,Sil-Select Plus and SpermGrad preparations,respectively （P〈0.05）. The percentage of DNA-damaged sperm was negatively correlated with the percentages of sperm motility,rapid motility and PMC,but was positively correlated with static motility （P〈0.05）. This comparative study and correlation analysis revealed that PureSperm preparation yielded sperm with the best motility and the lowest percentage of protamine deficiency. The Sil-Select Plus preparation yielded sperm with the lowest amount of DNA damage. The SpermGrad preparation had a high percentage of sperm with normal morphology,but also had the highest percentage of sperm with DNA damage. Sperm DNA damage was correlated with percentages of sperm motility,rapid motility,static motility and PMC.展开更多
Objective:To compare the pregnancy rate between day 3 and day 5 transfer regardless grades of embryos and number of transferred embryo.Methods: Retrospective cohort, a total of seven hundred and four patients met our ...Objective:To compare the pregnancy rate between day 3 and day 5 transfer regardless grades of embryos and number of transferred embryo.Methods: Retrospective cohort, a total of seven hundred and four patients met our inclusion criteria, with 411 had day 3 embryo transfer and 293 had day 5 embryo transfer. The patients who were older than 40 years old were excluded. Embryo transfer was carried out in all patients in both transfer groups.Results:Both clinical pregnancy rate and implantation rate did not show any statistically significant difference between the day 3 and day five transfer groups. These were 44%vs. 45% withP=0.82 and 19%vs. 19% withP=0.99 respectively. An increase of miscarriage rate with day 5 embryo transferred compare with day 3 (12.0%vs. 4.4%,P=0.01), but no significant difference was found about biochemical pregnancy rate (P=0.52).Conclusions:Transferring embryo at day 5 may not provide any additional benefit over day 3 transfers to patients. In addition, it increases the risk of miscarriage. Further studies of this issue needed for confirming our findings.展开更多
Image noise analysis of a large ring PET scanner “macro PET” performed using two different phantoms, namely a Jaszczak SPECT phantom and a uniform cylindrical phantom. In the present work, simple 2D filtered back pr...Image noise analysis of a large ring PET scanner “macro PET” performed using two different phantoms, namely a Jaszczak SPECT phantom and a uniform cylindrical phantom. In the present work, simple 2D filtered back projection was used to reconstruct all the images, and in almost all the cases a Hamming filter of cutoff frequency 0.4 and a 256 by 256 matrix with zoom factors from 1 to 4 were used in order to investigate the imaging capabilities of the new scanner and the influence of filter and cut-off frequency on the filtered back projected images. Results indicate that 11.1 mm cold rod in the Jaszczak phantom images can consistently be seen. The Coefficient of variation (CV) results for Hann and Hamming filters are very similar and increase approximately in linear fashion with higher cutoff frequency. The value of CV for the Parsen filter is lower than the value for Hann and Hamming filters. It concludes that all filters with low cut off-frequency (0.6) would suppress image noise but decrease contrast.展开更多
<strong>Background:</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Cerebral palsy is the m...<strong>Background:</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Cerebral palsy is the most common chronic motor disability that begins in childhood with the predominant motor abnormality</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> that</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> is spasticity</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span><span><span style="font-family:""> <b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> The purpose of the present study was to compare the efficacy of oral baclofen and oral tizanidine in reducing spasticity in cerebral palsy patients. </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:Verdana;">This randomized controlled trial was conducted from January 2010 to December 2011 and it was carried out in the Out Patient Department (OPD) of Pediatrics at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh and Center for Neurodevelopment and Autism in Children (CNAC) of Bangabandhu Sheikh Mujib Medical University (B中央人民政府), Dhaka, Bangladesh. </span><b><span style="font-family:Verdana;">Results</span></b><span style="font-family:Verdana;">: A total number of 70 cerebral palsy children were recruited for this study of which 35 patients were in </span><span style="font-family:Verdana;">Tizanidine</span><span style="font-family:Verdana;"> group and 35 patients were in </span><span style="font-family:Verdana;">baclofen</span><span style="font-family:Verdana;"> group. </span><span style="font-family:Verdana;">Furthermore</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> 70 cerebral palsy children were taken as control who were treated with </span><span style="font-family:Verdana;">placebo</span><span style="font-family:Verdana;">. Tizanidine had superior efficacy in reducing tone in spastic cerebral palsy over baclofen measured by using </span><span style="font-family:Verdana;">Modified</span><span style="font-family:Verdana;"> Ashworth scale in </span><span style="font-family:Verdana;">different</span> <span style="font-family:Verdana;">time period</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> from AS score-3 to score-2 (p < 0.05). Tizanidine was also superior in joint angle improvement in spastic cerebral palsy measured by </span><span style="font-family:Verdana;">physician</span><span style="font-family:Verdana;"> rating scale from AS score-3 to score-2 (crouch p < 0.0001) and foot contact from AS score-3 to score-2 (p < 0.0001);but no statistically significant improvement in gross motor function. </span><span style="font-family:Verdana;">Adverse</span><span style="font-family:Verdana;"> effect </span><span style="font-family:Verdana;">w</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">as</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> more in </span><span style="font-family:Verdana;">baclofen</span><span style="font-family:Verdana;"> group. </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: For reducing generalized spasticity with regards to muscle tone, joint angle </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> improvement in gait in cerebral palsy patients, tizanidine has superior efficacy and less adverse effects than baclofen.</span></span></span></span>展开更多
Image contrast recovery coefficient (CRC) of a large ring PET scanner “macroPET” was studied with septa and without septa configuration by ac-quiring data from a laboratory made 35.7 cm square phantom filled with 18...Image contrast recovery coefficient (CRC) of a large ring PET scanner “macroPET” was studied with septa and without septa configuration by ac-quiring data from a laboratory made 35.7 cm square phantom filled with 18-F. Images were reconstructed with simple 2D filtered back projection using Hann, Hamming and Parsen filters with different cut-off frequencies aiming to investigate the influence of filter and cut-off frequency on image contrast with septa and without septa mode. Results indicate that the CRC, for both hot and cold lesions, is excellent for diameters ≥ 3 cm using cut-off frequencies > 0.4. For a 2 cm hot lesion CRC is around 0.8 to 0.9. CRC for 1 cm hot and cold lesions is ~0.3, as expected. There is surprisingly little difference between results with and without septa. For hot lesions, septa appear to improve CRC slightly, but for cold lesions CRC is slightly poorer using septa.展开更多
Objective: To clarify whether the presence of ovarian endometriomas is associated with a reduced responsiveness to ovarian hyperstimulation. Design: Observational study. Setting: University teaching hospital. Patient(...Objective: To clarify whether the presence of ovarian endometriomas is associated with a reduced responsiveness to ovarian hyperstimulation. Design: Observational study. Setting: University teaching hospital. Patient(s)- : Women selected for in vitro fertilization intracytoplasmic sperm injection (IVF-ICSI) cycles who were found to have unilateral ovarian endometriomas and who did not undergo previous ovarian surgery. Intervention(s): Ovarian hyperstimulation using gonadotropins. Main Outcome Measure(s): Number of codominant follicles (mean diameter > 15 mm) in the affected and in the contralateral intact gonads. Result(s): Thirty-six patients were enrolled. They underwent 56 IVF-ICSI cycles. The number of codominant follicles in the intact and affected ovaries were 4.0 ± 2.2 and 3.0 ± 1.7, respectively (P = .01)-. This difference corresponded to a mean reduction (95% confidence interval [CI]) of 25% (6% - 44% ). This deleterious effect was more evident in women with larger cysts, in those with more than one cyst, and in those who were more responsive to ovarian hyperstimulation. Conclusion(s): The presence of ovarian endometriomas is associated with a reduced responsiveness to gonadotropins.展开更多
Objective: To employ protocols of mild ovarian stimulation to prevent an excessively elevated rate of high- order multiple pregnancies. Design: Case series. Setting: University hospital. Patient(s): Six hundred and tw...Objective: To employ protocols of mild ovarian stimulation to prevent an excessively elevated rate of high- order multiple pregnancies. Design: Case series. Setting: University hospital. Patient(s): Six hundred and twenty one consecutive patients undergoing 1,259 controlled ovarian hyperstimulation and intrauterine insemination cycles. Intervention(s): Patients received 50 IU per day of recombinant follicle- stimulating hormone (FSH) starting the third day of the cycle, then a gonadotropin- releasing hormone (GnRH) antagonist on the day in which a follicle<13 mm was visualized. Cycles were canceled if three or more follicles < 16 mm and/or five or more follicles < 11 mm were detected. Main Outcome Measure(s): Rate of high- order multiple pregnancies. Result(s): The clinical pregnancy rate per initiated cycle was 9.2% (95% confidence interval, 7.5- 11.1% ). The incidence of twins and high- order multiple pregnancies was 9.5% (95% CI, 5.3- 16.2% ) and 0 (0.0- 3.2% ), respectively. Conclusion(s): In controlled ovarian hyperstimulation and intrauterine insemination cycles, a protocol of 50 IU of recombinant FSH daily combined with the use of GnRH antagonists and a policy of strict cancellation based on echographic criteria are associated with a satisfactory pregnancy rate per initiated cycle and a low risk of high- order multiple pregnancies.展开更多
文摘We aimed to determine the impact of metabolic syndrome （MetS） on reproductive function in men with secondary infertility, a condition that has received relatively little attention from researchers. Complete demographic, clinical, and laboratory data from 167 consecutive secondary infertile men were analyzed. Health-significant comorbidities were scored with the Charlson Comorbidity Index （CCI; categorised 0 vs I vs 2 or higher）. NCEP-ATP III criteria were used to define MetS. Semen analysis values were assessed based on the 2010 World Health Organization （WHO） reference criteria. Descriptive statistics and logistic regression models tested the association between semen parameters and clinical characteristics and MetS. MetS was found in 20 （12%） of 167 men. Patients with MetS were older （P 〈 0.001） and had a greater BMI （P 〈 0.001） compared with those without MetS. MetS patients had lower levels of total testosterone （P = 0.001）, sex hormone-binding globulin, inhibin B, and anti-MOIlerian hormone （all P 〈 0.03）, and they were hypogonadal at a higher prevalence （P = 0.01） than patients without MetS. Moreover, MetS patients presented lower values of semen volume, sperm concentration, and sperm normal morphology （all P≤0.03）. At multivariate logistic regression analysis, no parameters predicted sperm concentration, normal sperm morphology, and total progressive motility. Our data show that almost 1 of 8 White-European men presenting for secondary couple＇s infertility is diagnosed with MetS. MetS was found to be associated with a higher prevalence of hypogonadism, decreased semen volume, decreased sperm concentration, and normal morphology in a specific cohort of White-European men.
文摘Semen samples collected from 28 male partners of infertile couples were divided into three equal aliquots and prepared with three selected media,such as PureSperm （Nidacon,Gothenburg,Sweden）,Sil-Select Plus^TM （Fertipro,Beemem,Belgium） and SpermGrad^TM（Vitrolife,Gothenburg,Sweden）. The differences in mean percentages of semen parameters were assessed by repeated measures analysis. Correlations of sperm DNA damage,as measured by terminal deoxynucleotidyl transferase dUTP nick end labeling （TUNEL） assay,and of protamine deficiency,as measured by chromomycin A3 （CMA3） staining with sperm parameters,were determined by Pearson＇s correlation. After preparation with all three media,sperm concentrations decreased （P〈0.05） while percentages of sperm with normal morphology increased （P〈0.05）. Percentages of sperm motility,rapid motility and progressive motile concentration （PMC） increased （P〈0.05） for each ofthese parameters,PureSperm preparation gave the best results （P〈0.05）. The percentage of DNA damage decreased in the PureSperm and Sil-Select Plus preparations （17.9% and 31.3%,respectively,P〈0.05） and increased in the SpermGrad preparation （56.3%,P〈0.05）. Protamine deficiency also decreased in all three kinds of media,59.3%,47.7% and 40.3% for PureSperm,Sil-Select Plus and SpermGrad preparations,respectively （P〈0.05）. The percentage of DNA-damaged sperm was negatively correlated with the percentages of sperm motility,rapid motility and PMC,but was positively correlated with static motility （P〈0.05）. This comparative study and correlation analysis revealed that PureSperm preparation yielded sperm with the best motility and the lowest percentage of protamine deficiency. The Sil-Select Plus preparation yielded sperm with the lowest amount of DNA damage. The SpermGrad preparation had a high percentage of sperm with normal morphology,but also had the highest percentage of sperm with DNA damage. Sperm DNA damage was correlated with percentages of sperm motility,rapid motility,static motility and PMC.
文摘Objective:To compare the pregnancy rate between day 3 and day 5 transfer regardless grades of embryos and number of transferred embryo.Methods: Retrospective cohort, a total of seven hundred and four patients met our inclusion criteria, with 411 had day 3 embryo transfer and 293 had day 5 embryo transfer. The patients who were older than 40 years old were excluded. Embryo transfer was carried out in all patients in both transfer groups.Results:Both clinical pregnancy rate and implantation rate did not show any statistically significant difference between the day 3 and day five transfer groups. These were 44%vs. 45% withP=0.82 and 19%vs. 19% withP=0.99 respectively. An increase of miscarriage rate with day 5 embryo transferred compare with day 3 (12.0%vs. 4.4%,P=0.01), but no significant difference was found about biochemical pregnancy rate (P=0.52).Conclusions:Transferring embryo at day 5 may not provide any additional benefit over day 3 transfers to patients. In addition, it increases the risk of miscarriage. Further studies of this issue needed for confirming our findings.
文摘Image noise analysis of a large ring PET scanner “macro PET” performed using two different phantoms, namely a Jaszczak SPECT phantom and a uniform cylindrical phantom. In the present work, simple 2D filtered back projection was used to reconstruct all the images, and in almost all the cases a Hamming filter of cutoff frequency 0.4 and a 256 by 256 matrix with zoom factors from 1 to 4 were used in order to investigate the imaging capabilities of the new scanner and the influence of filter and cut-off frequency on the filtered back projected images. Results indicate that 11.1 mm cold rod in the Jaszczak phantom images can consistently be seen. The Coefficient of variation (CV) results for Hann and Hamming filters are very similar and increase approximately in linear fashion with higher cutoff frequency. The value of CV for the Parsen filter is lower than the value for Hann and Hamming filters. It concludes that all filters with low cut off-frequency (0.6) would suppress image noise but decrease contrast.
文摘<strong>Background:</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Cerebral palsy is the most common chronic motor disability that begins in childhood with the predominant motor abnormality</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> that</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> is spasticity</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span><span><span style="font-family:""> <b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> The purpose of the present study was to compare the efficacy of oral baclofen and oral tizanidine in reducing spasticity in cerebral palsy patients. </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:Verdana;">This randomized controlled trial was conducted from January 2010 to December 2011 and it was carried out in the Out Patient Department (OPD) of Pediatrics at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh and Center for Neurodevelopment and Autism in Children (CNAC) of Bangabandhu Sheikh Mujib Medical University (B中央人民政府), Dhaka, Bangladesh. </span><b><span style="font-family:Verdana;">Results</span></b><span style="font-family:Verdana;">: A total number of 70 cerebral palsy children were recruited for this study of which 35 patients were in </span><span style="font-family:Verdana;">Tizanidine</span><span style="font-family:Verdana;"> group and 35 patients were in </span><span style="font-family:Verdana;">baclofen</span><span style="font-family:Verdana;"> group. </span><span style="font-family:Verdana;">Furthermore</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> 70 cerebral palsy children were taken as control who were treated with </span><span style="font-family:Verdana;">placebo</span><span style="font-family:Verdana;">. Tizanidine had superior efficacy in reducing tone in spastic cerebral palsy over baclofen measured by using </span><span style="font-family:Verdana;">Modified</span><span style="font-family:Verdana;"> Ashworth scale in </span><span style="font-family:Verdana;">different</span> <span style="font-family:Verdana;">time period</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> from AS score-3 to score-2 (p < 0.05). Tizanidine was also superior in joint angle improvement in spastic cerebral palsy measured by </span><span style="font-family:Verdana;">physician</span><span style="font-family:Verdana;"> rating scale from AS score-3 to score-2 (crouch p < 0.0001) and foot contact from AS score-3 to score-2 (p < 0.0001);but no statistically significant improvement in gross motor function. </span><span style="font-family:Verdana;">Adverse</span><span style="font-family:Verdana;"> effect </span><span style="font-family:Verdana;">w</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">as</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> more in </span><span style="font-family:Verdana;">baclofen</span><span style="font-family:Verdana;"> group. </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: For reducing generalized spasticity with regards to muscle tone, joint angle </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> improvement in gait in cerebral palsy patients, tizanidine has superior efficacy and less adverse effects than baclofen.</span></span></span></span>
文摘Image contrast recovery coefficient (CRC) of a large ring PET scanner “macroPET” was studied with septa and without septa configuration by ac-quiring data from a laboratory made 35.7 cm square phantom filled with 18-F. Images were reconstructed with simple 2D filtered back projection using Hann, Hamming and Parsen filters with different cut-off frequencies aiming to investigate the influence of filter and cut-off frequency on image contrast with septa and without septa mode. Results indicate that the CRC, for both hot and cold lesions, is excellent for diameters ≥ 3 cm using cut-off frequencies > 0.4. For a 2 cm hot lesion CRC is around 0.8 to 0.9. CRC for 1 cm hot and cold lesions is ~0.3, as expected. There is surprisingly little difference between results with and without septa. For hot lesions, septa appear to improve CRC slightly, but for cold lesions CRC is slightly poorer using septa.
文摘Objective: To clarify whether the presence of ovarian endometriomas is associated with a reduced responsiveness to ovarian hyperstimulation. Design: Observational study. Setting: University teaching hospital. Patient(s)- : Women selected for in vitro fertilization intracytoplasmic sperm injection (IVF-ICSI) cycles who were found to have unilateral ovarian endometriomas and who did not undergo previous ovarian surgery. Intervention(s): Ovarian hyperstimulation using gonadotropins. Main Outcome Measure(s): Number of codominant follicles (mean diameter > 15 mm) in the affected and in the contralateral intact gonads. Result(s): Thirty-six patients were enrolled. They underwent 56 IVF-ICSI cycles. The number of codominant follicles in the intact and affected ovaries were 4.0 ± 2.2 and 3.0 ± 1.7, respectively (P = .01)-. This difference corresponded to a mean reduction (95% confidence interval [CI]) of 25% (6% - 44% ). This deleterious effect was more evident in women with larger cysts, in those with more than one cyst, and in those who were more responsive to ovarian hyperstimulation. Conclusion(s): The presence of ovarian endometriomas is associated with a reduced responsiveness to gonadotropins.
文摘Objective: To employ protocols of mild ovarian stimulation to prevent an excessively elevated rate of high- order multiple pregnancies. Design: Case series. Setting: University hospital. Patient(s): Six hundred and twenty one consecutive patients undergoing 1,259 controlled ovarian hyperstimulation and intrauterine insemination cycles. Intervention(s): Patients received 50 IU per day of recombinant follicle- stimulating hormone (FSH) starting the third day of the cycle, then a gonadotropin- releasing hormone (GnRH) antagonist on the day in which a follicle<13 mm was visualized. Cycles were canceled if three or more follicles < 16 mm and/or five or more follicles < 11 mm were detected. Main Outcome Measure(s): Rate of high- order multiple pregnancies. Result(s): The clinical pregnancy rate per initiated cycle was 9.2% (95% confidence interval, 7.5- 11.1% ). The incidence of twins and high- order multiple pregnancies was 9.5% (95% CI, 5.3- 16.2% ) and 0 (0.0- 3.2% ), respectively. Conclusion(s): In controlled ovarian hyperstimulation and intrauterine insemination cycles, a protocol of 50 IU of recombinant FSH daily combined with the use of GnRH antagonists and a policy of strict cancellation based on echographic criteria are associated with a satisfactory pregnancy rate per initiated cycle and a low risk of high- order multiple pregnancies.
