Treatment strategies and cumulative live birth rates in WHO-II ovulation disorders

Sanne C. Braam, Jan Peter de Bruin, Erato T.I.A. Buisman, Monique Brandes, Willianne L.D.M. Nelen, Jesper M.J. Smeenk, Jan Willem van der Steeg, Ben Willem J. Mol, Carl J.C.M. Hamilton

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10 Citations (Scopus)


Objective: To assess the live birth rate in women with WHO II anovulation and the proportion of women that need second or third line treatments if the initial therapy fails. Study design: In this multicenter cohort study we included couples with unfulfilled child wish who were referred to three fertility clinics in the Netherlands and selected women with a WHO II ovulation disorder as the only final infertility diagnosis (n = 468). Results: The cumulative live birth rate of the total group was 82% (383/468). The majority started with clomiphene-citrate as first-line treatment (n = 378) resulting in 180 (48%) live births. There were 153 couples (40%) who underwent a second-line treatment (recombinant-FSH or laparoscopic electrocoagulation of the ovaries, LEO) and 52 couples (14%) a third-line treatment (IVF/ICSI), resulting in 44% and 63% treatment dependent live births rates, respectively. Of all couples, 92 (20%) conceived naturally, 186 (40%) after clomiphene-citrate, 60 (13%) after recombinant-FSH, nine (2%) after LEO and 36 (8%) after IVF. Conclusion: Subfertile women with a WHO II ovulation disorder have a good prognosis on live birth, and most did so after ovulation induction with clomiphene-citrate. If first-line ovulation induction has failed ovulation induction with gonadotrophins or IVF still result in a live birth in about half of the cases.

Original languageEnglish
Pages (from-to)84-89
Number of pages6
JournalEuropean Journal of Obstetrics and Gynecology and Reproductive Biology
Publication statusPublished or Issued - Jun 2018
Externally publishedYes


  • Cumulative live birth rate
  • Infertility
  • Ovulation disorders

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

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