A novel, simplified and cost effective protocol for superovulation and intrauterine insemination.

OBJECTIVE To determine the efficacy and cost of a simplified superovulation regimen compared with traditional control ovarian hyperstimulation with gonadotropins (HMG). STUDY DESIGN This was a retrospective study in a university referral center with 99 infertile couples undergoing 225 treatment cycles. The outcome was compared to outcomes of previously published studies. The simplified superovulation regimen included clomiphene citrate 100 mg on cycle days 5 through 9 and HMG 75 IU on cycle days 5, 7, 9, and 11, with estradiol and ultrasound monitoring on day 13. If adequate follicular maturity was documented, HCG 10,000 IU was administered, followed by intrauterine insemination 40 hours later. RESULTS Fecundity rates were assessed by life table analysis. Average cycle fecundity was 8%, with a cumulative rate of 29% over 4 cycles, compared to 10% monthly fecundity with HMG/IUI and background rates of 1 to 3%. Costs averaged $662 per cycle compared to $1,854 with HMG/IUI. CONCLUSION A simplified protocol of CC/HMG/ IUI is almost as effective as HMG/IUI and costs only one-third as much.