Skip to main content
Oral ovulation induction agents combined with low-dose gonadotropin injections and intrauterine insemination: cost- and clinical effectiveness
The Journal of reproductive medicine
  • Ginny L. Ryan, University of Iowa
  • V. Moss
  • W. A. Davis
  • Amy E.T. Sparks, University of Iowa
  • A. Dokras
  • Bradley J. Van Voorhis, University of Iowa
Document Type
Peer Reviewed
Publication Date
NLM Title Abbreviation
J Reprod Med
PubMed ID
OBJECTIVE: To compare the efficacy and cost-effectiveness of different induction protocols involving gonadotropins with intrauterine insemination (IUI). STUDY DESIGN: We performed a retrospective chart review of 648 IUI cycles. Some patients had gonadotropin injections alone before human chorionic gonadotropin (hCG) and IUI (human menopausal gonadotropin protocol); others were given oral medications, then gonadotropins before hCG and IUI (combination protocol). Outcomes included pregnancy rates, multiple birth rates, endometrial thickness, number of ovarian follicles, injection days, ampules of gonadotropins and cost. RESULTS: The combination protocol was more cost-effective. In first cycles, pregnancy rates, multiple birth rates, number of large follicles produced and cancellation rates were similar. The combination group had fewer days of injections and fewer ampules used. When all cycles were analyzed, the multiple birth rate was lower in the combination group. Comparing the different oral medications in the combination protocols, letrozole yielded higher pregnancy rates than tamoxifen or clomiphene. Multiple birth rates were similar for all oral medications. CONCLUSION: Combination protocols are less costly and equally effective, with potentially fewer multiple births than with gonadotropins alone. Letrozole may be more effective than clomiphene and tamoxifen in a combination protocol.
  • Administration,
  • Oral,
  • Adult,
  • Analysis of Variance,
  • Clomiphene/administration & dosage/economics,
  • Cost-Benefit Analysis,
  • Female,
  • Fertility Agents,
  • Female/administration & dosage/economics,
  • Humans,
  • Infertility/therapy,
  • Injections,
  • Insemination,
  • Artificial/economics/methods,
  • Menotropins/administration & dosage/economics,
  • Nitriles/administration & dosage/economics,
  • Ovulation Induction/economics/methods,
  • Pregnancy,
  • Pregnancy Rate,
  • Retrospective Studies,
  • Tamoxifen/administration & dosage/economics,
  • Triazoles/administration & dosage/economics
Published Article/Book Citation
The Journal of reproductive medicine, 50:12 (2005) pp.943-950.
Citation Information
Ginny L. Ryan, V. Moss, W. A. Davis, Amy E.T. Sparks, et al.. "Oral ovulation induction agents combined with low-dose gonadotropin injections and intrauterine insemination: cost- and clinical effectiveness" The Journal of reproductive medicine Vol. 50 Iss. 12 (2005) p. 943 - 950 ISSN: 0024-7758
Available at: