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Poor Responder 환자에서 Clomiphene Citrate 주기와 Controlled Ovarian Hyperstimulation 주기의 체외수정 결과 비교
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  • Poor Responder 환자에서 Clomiphene Citrate 주기와 Controlled Ovarian Hyperstimulation 주기의 체외수정 결과 비교
  • Efficacy of Clomiphene Citrate Stimulated Cycle in Poor Responders in in vitro Fertilization
저자명
송지홍,궁미경,Song. Ji-Hong,Koong. Mi-Kyoung
간행물명
大韓不妊學會雜誌
권/호정보
1998년|25권 3호|pp.239-244 (6 pages)
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이 논문은 한국과학기술정보연구원과 논문 연계를 통해 무료로 제공되는 원문입니다.
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기타언어초록

The purpose of this study is compare IVF cycle outcome in poor responders between clomiphene citrate (CC) stimulated and controlled ovarian hyperstimulation (COH) protocol. A total of 94 patients responding poorly in previous IVF cycles (estradiol<600 pg/ml or less than 3 oocytes retrieved) subsequently underwent either COH (COH group: 122 cycles, 68 patients) or CC-stimulated cycles (CC group: 43 cycles, 26 patients). CC was administered for five consecutive days starting on cycle day 3 at a dose of 100 mg daily. Serial transvaginal ultrasound examination was done from cycle day 8. Urine was collected $3sim4$ times before hCG injection for the detection of LH surge. The hCG was administered when serum estradiol reached greater than 150 pg/ml and mean follicle diameter>16 mm. In COH group, ovarian stimulation was done using short protocol (GnRH-a/FSH/HMG/hCG). No difference in age or number of transferred embryos was found between CC group and COH group. COH group had significantly (p<0.05) higher mean peak level of $E_2$ ($810{pm}112$ vs $412{pm}55$ pg/ml) and greater number of retrieved oocytes ($3.0{pm}0.2$ vs $2.0{pm}0.2$) than CC group. CC group had transferred embryos $(1.8{pm}0.2)$ compared with $(2.1{pm}0.2)$ in COH group. However, CC group had higher pregnancy rate than COH group per retrieval [26.9% (7/26) vs 6.2% (6/97)], or per transfer [31.8% (7/22) vs 7% (6/86)]. Although cycle cancellation rate in CC group (48.8%) was higher than that of COH group (21.3%), the pregnancy rate per cycle in CC group was still higher (16.3%) than COH group (4.9%). In addition, implantation rate in CC group was 17.5% (7/40), which was significantly (p<0.01) higher than 3.9% (7/180) in COH group. These data suggest that oocyte and embryo quality are lower in COH cycles of poor responders than CC cycles. We suggest that clomiphene citrate stimulated IVF cycle may be more efficient than COH IVF cycle in poor responders in terms of lower costs and higher pregnancy performance.