ASSISTED REPRODUCTIVE TECHNOLOG Y FOR UNEXPLQINED INFERTILITY

Abstract

group indicating a milder form of gafl!ele problems in unexplam. ed'

group.

infertility

• ;., '

Treatment in couj1les with uhexf!lained infertility is controversial.i However, it is recognized that •s]Jontaneous pregnane; rates• are disappointing;y Jo, J.-hen , I . : . . , duration of infertility is prolonged and therefore advanced ai1d sophisticated forms , , ' I ' of treatment apper to be justified. In, studies with variable p tient ,selection

criteria, spontaneous fecundity rates per cycle in couples with long1standing I I

I ''

i :11 I I I

infertility was appt'oximately 2%, ranging from' 0.71% to 3.97%. However, pri<ir C;

studies for treatmynt of unexplained infertility indicated that the us6f any method of assisted :coi1ception increased the pregnancy rate beyond that expected from suiJerovulati?n alone. The combination of superovulation• and lUI , or ' intraperitoneal inse:mination, UJJ1T, or IVF-ETyielde\1 sin hir per cycle fecundity . rates. These :resultindicate that, before embarking upon more complex forms of

treatment necessitating extensive laboratory setup, superovulation combined with lUI or intraperit01ieal insemination should be attempted. It is, however, unknown whether Jack of conception with such treatment options dictates a.less favorable ' . ' , progno is• f0r futu •e attempts at more c mplcx fornis of assisted conception

methodssuch as IV,F-ET (418-421). . ' 1, '!• . ; I I '

Mostitm;stigators!b Ji ve that couples wit nexplai ed ii1fertility .failing to

1 concetve fler four t<;six

cycles of superovulalton and lUI have .relattvely .good

, I ,, . , .

! conceptiotl rats in 1

t IVF-ET cycleS. :Furtherin'ore, fertilization failure in

' couples with unexplai1>1ed infertility appeared to be repetitive compared with tubal

factor patients. Fertilization rates were similr in the two groups when events of total fertilization failure were excluded from analysis of the data, which goes with the results obtained in our study. The per-cycle and per-embryo transfer (ET) ' pregnancy rates were 32.4 and 37.3% in the overall Ul group and 24 and 24.5% m the control group. The miscarriage rate was 12% in the strict Ul group, 22% in the overall Ul group, and 25% in the control group. It is concluded that patients with . ' . Ul constitute a fa orable group for in vitro fertilization and ET (20, 2.6).