Semi-programmed ovarian stimulation as the first choice in in-vitro fertilization programmes

The objective of this work was to evaluate the results obtained with a protocol of semi-programmed ovarian stimulation (low-dose contraceptive pill+clomiphene citrate+human menopausal gonadotrophin+dexamethasone) used as the first-choice method for in-vitro fertilization (IVF). A total of 207 punctures was performed for oocyte collection from 168 patients (mean age 31.0 +/- 4.0 years); mean infertility duration was 5.81 +/- 3.30 years. The infertility factors indicating IVF for this population were as follows: tubo-peritoneal factor, 68%; pure or associated male factor, 9.2%; endometriosis, 11.1%; ovulatory factor, 4.3%; idiopathic factor, 11.6%; others, 2.4%. No oocyte was found on aspiration in five procedures (2.4%), with the mean number of oocytes collected per cycle being 5.87 +/- 3.3 (range 0-18). The cancellation rate per puncture was 5%. The mean embryo cleavage rate was 60.2 +/- 36.8%, with transfer of at least one embryo occurring in 82.6% of all punctures. The mean number of transferred embryos was 2.52 +/- 1.60 (range 1-5). The clinical pregnancy rates per started cycle and per puncture were 22.4 (218 ovarian stimulation cycles) and 23.6% (a total of 49 clinical pregnancies, 36 single, nine twins and four triplets) respectively. The clinical pregnancy rate per embryo transfer was 28.6%. The embryo implantation rate was 12.6%. The abortion rate was 16.3%. The index of deliveries per puncture was 19.8%. There were no cases of moderate or severe ovarian hyperstimulation syndrome.