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  • Title: Association of the number of follicles of various sizes and treatment protocol with multiple pregnancies following ovulation induction and intrauterine insemination.
    Author: Moosavifar N, Aliakbarzadeh M, Shakeri M.
    Journal: J Pak Med Assoc; 2008 Jan; 58(1):18-22. PubMed ID: 18297970.
    Abstract:
    OBJECTIVE: To find the relationship between the number of follicles of different sizes and the stimulation protocol to the probability of multiple pregnancies. METHODS: Out of 2034 cycles of OI-IUI in a university based infertility center, between March 2003 to March 2006, there were 322 clinically pregnant cycles. The following variables were tabulated for each cycle: female age, treatment protocol, follicle number and size on the day of hCG administration and number of gestational sacs detected by transvaginal ultrasonography at 9 weeks of gestation. Ovulation induction was done by cc, cc+hMG or hMG. Follicles were categorized by size as = 18mm, = 15mm and = 12mm. To find the relationship between singleton and multiple pregnancy with the average number of follicles of different sizes and the protocol of treatment, a statistical analysis was performed. RESULTS: There were 38 (11.8%) multiple pregnancies in 322 pregnant cycles. consisting of 26 (8.1%) twin, 11 (3.4%) triplet and 1 (0.3%) quintuplet. Multiple pregnancy rate in cc, cc+hMG and hMG cycles were 9.01%, 12.2% and 15% respectively. There was no significant relationship between different treatment protocols and the risk of multiple pregnancy (p > 0.1). The number of follicles > or = 12 mm or > or = 15 mm or > or = 18 mm had significant relationship with single and multiple pregnancies (p < 0.01), but the correlation coefficient was higher for > or = 18 mm follicles. The mean age of the singleton and multiple pregnant women was not significantly different (p > 0.1). CONCLUSIONS: The risk of multiple conceptions is related to > or = 18 mm follicles in addition to the total number of follicles >12 mm. Different protocol of ovulation induction revealed no relationship with the risk of multiple conceptions.
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