TWO DAYS MINIMAL STIMULATION PROTOCOL WITH INTRAUTERINE INSEMINATION IN THE TREATMENT OF UNEXPLAINED INFERTILITY

Objective: To determine whether minimal stimulation with clomiphene and one injection of 150 IU of human menopausal gonadotrophin (hMG) provides pregnancy rates comparable with those in a conventional full hMG stimulation protocol for unexplained infertile patients undergoing intrauterine insemination (IUI). Methods: A prospective study was carried out at the Infertility Clinic of Elshorok hospital Benha Egypt. Two hundred couples with either unexplained infertility or ovulatory dysfunction cases who ovulated with clomiphene citrate (CC) but failed to conceive were offered ovarian stimulation with CC and hMG along with IUI for 200 cycles. Patients divided into two groups according to the stimulation protocol in group one patients given clomiphene citrate 50mg from day 3 to 7 two tablets per day with hMG (merional )75 unit injection on day 5 and 7 .in group two (full stimulation regimen clomiphene citrate given with hMG injection from day 5 to 9 daily then dose adjusted according to finding on trans-vaginal ultrasound scan of follicles . Pregnancy rate, medication and monitoring cost were compared between minimal and conventional stimulation protocols. Results: Number of ampoules of hMG and monitoring costs were significantly higher in the full hMG stimulation cases whereas pregnancy rate was comparable in both protocols. Conclusion: Minimal stimulation appears to be an effective protocol in cases of unexplained infertility undergoing intrauterine insemination.