الفهرس | Only 14 pages are availabe for public view |
Abstract Objectives: 1.To review the literature for the use of clomifene citrate in IVF 2.To compare the clomifene/gonadotropins protocol to the long GnRH agonist/gonadotropins protocol, for COH in low income couples undergoing ICSI treatment, in Mansoura Fertility Care Unit (MFCU). 3. To examine the association between the total dose of gonadotropins and IVF outcomes. Patients and methods: We performed a systematic review and meta-analysis of published randomized trials comparing the clomifene/gonadotropins protocol to the long or short GnRH agonist/gonadotropins protocol. We conducted a prospective non-randomized trial on 88 couples undergoing ICSI treatment, in Mansoura Fertility Care Unit (MFCU). A cross sectional retrospective study examining the associations between total gonadotropins used in controlled ovarian hyperstimulation (COH) and IVF/ICSI outcomes. Results and conclusion: Our prospective comparative trial has shown the clomifene citrate/HMG not to be associated with significantly lower pregnancy rate than the long GnRH agonist protocol. There was no evidence from the systematic review and meta-analysis that the use of GnRHa/gonadotropins pituitary down regulation long or short protocol is associated with a significant increase in live birth rate or pregnancy rate compared to the clomifene/gonadotropins protocol. In addition, our retrospective analysis pointed out to an association between higher total dose of gonadotropins and impaired clinical pregnancy rates. |