HORMONE AND ULTRASOUND PARAMETERS IN OVARIAN STIMULATION CYCLES FOR DIRECT INTRAPERITONEAL INSEMINATION

To determine hormonal and ultrasound parameters associated with pregnancies, 115 women with unexplained infertility (n = 82), endometriosis (n = 22) or cervical factor (n = 11) were treated with direct intraperitoneal insemination (DIPI) after ovarian stimulation with clomiphene citrate and human menopausal gonadotrophins (HMG). Twenty women conceived and were compared with the remaining 95 nonpregnant women during one treatment cycle. Women with basal FSH levels less-than-or-equal-to 1.25-mu-g/l responded with higher oestradiol levels (P < 0.0001), with the development of more follicles (P < 0.05) and higher progesterone levels (P < 0.05) than women with basal FSH levels > 1.25-mu-g/l, but the conception rates were similar. Women with miscarriages or biochemical pregnancies had a higher basal FSH value than both the women with term pregnancies and the non-pregnant women. Women with at least 3 preovulatory follicles greater-than-or-equal-to 15 mm had a higher pregnancy rate than those with fewer follicles, but a further increase was not observed above that number. The endometrium was thicker on the day of ovulation induction in cycles leading to a term pregnancy than in cycles without conception or with a biochemical pregnancy. No term pregnancy was observed when the endometrium was thinner than 8 mm. Women with a short luteal phase (< 12 days) had a higher ratio of oestradiol/progesterone in the midluteal phase than women with a luteal phase of greater-than-or-equal-to 12 days and pregnant women. To conclude, the best results were obtained with DIPI in clomiphene citrate/HMG cycles with three follicles greater-than-or-equal-to 15 mm and an endometrial thickness of greater-than-or-equal-to 8 mm