Assessing the risk of multiple gestation in gonadotropin intrauterine insemination cycles

Am J Obstet Gynecol. 2002 Jun;186(6):1244-7; discussion 1247-9. doi: 10.1067/mob.2002.123739.

Abstract

Objective: The purpose of this study was to analyze factors for their ability to predict multiple gestation in women who undergo controlled ovarian hyperstimulation with gonadotropins (follicle-stimulating hormone/human menopausal gonadotropin) and intrauterine insemination.

Study design: This was a retrospective analysis of the clinical and laboratory variables that are associated with multiple gestation. Data for 6 variables in 678 cycles of gonadotropin/intrauterine insemination between 1990 and 1999 were analyzed with survival analysis, Cox regression analysis, and multiple logistic regression.

Results: There were 99 clinical pregnancies among 678 cycles (14.6% per cycle) in 306 women. Of the 14 women with multiple gestations (14.1% of pregnancies), 11 women had twins, 2 women had triplets, and 1 woman had quadruplets. Age, days of gonadotropin treatment, total dose of gonadotropin, and number of follicles that were >or=15 mm at the time of human chorionic gonadotropin administration were statistically significant predictors of multiple gestation in >or=1 of the statistical models.

Conclusion: The risk of multiple gestation with controlled ovarian hyperstimulation/intrauterine insemination in this study was relatively low. In addition to age, several controllable variables that are associated with multiple gestation were identified.

MeSH terms

  • Adult
  • Chorionic Gonadotropin / therapeutic use
  • Female
  • Follicle Stimulating Hormone / therapeutic use*
  • Forecasting
  • Humans
  • Insemination, Artificial, Homologous*
  • Menotropins / therapeutic use*
  • Ovarian Follicle / physiology
  • Pregnancy
  • Pregnancy Rate
  • Pregnancy, Multiple*
  • Probability
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis

Substances

  • Chorionic Gonadotropin
  • Menotropins
  • Follicle Stimulating Hormone