Unexplained infertility and ovulatory induction with menopausal gonadotropins

Unexplained infertility affects 30% of infertile couples. Management depends on duration of infertility and age of female partner. Ovulation induction, together with intrauterine insemination, is commonly offered to couples with infertility of unknown origin. Intrauterine insemination gained its popularity because it is simple, non-invasive and cost-effective technique. The association with pharmacological stimulation is suitable to induce follicular maturation. The most used drugs to induce ovulation are clomiphene citrate and menopausal or recombinant gonodotropins. The aim of this paper was to evaluate the success rate after homologous intrauterine insemination (IUI) combined with menopausal gonadotropins stimulation.

A total of 90 couples were evaluated. Twelve couples (13.3%) were excluded from the treatment (6 vaginal infections, 4 tubal occlusions and 2 male infertility). Informed consent was applied for every couple. The remaining 78 couples were divided in two groups: group A (39 couples) were inducted with menopausal gonadotropins, while group B (39 couples) underwent placebo (multivitamin).

In group A (gonadotropins) 25 (64.1%) pregnancies and 2 (5.1%) abortion were registered, while in group B (placebo) there were 7 (17.9%). pregnancies and 1 (2.5%) abortion.

Ovulation inductions with menopausal gonadotropins, together with intrauterine insemination, improves fecundity in patients with infertility of unknown origin without recur to more invasive techniques.