ABSTRACT
The objective of this study was to evaluate the efficacy of clomiphene citrate, human menopausal gonadotropin [HMG] and gonadotropin releasing hormone analogs [Gn Rh agonist] in ovarian stimulation for in vitro fertilization and to evaluate the efficacy of transvaginal ultrasonography and estradiol in monitoring ovulation. This work comprised 134 infertile women. The tubal factor was the only cause. Cases were classified into three groups: Group I [56 women] received clomiphene citrate and HMG, Group II [59 women] received HMG only, group III [19 women] received Gn Rh agonist and HMG. Human chorionic gonadotropin [HCG] was injected [5000 IU. IM] when at least two follicles were >17 mm and serum estradiol was > 600 pg /ml the response was monitored by serum estradiol and transvaginal ultrasonography, except in group II where 20 cases were monitored only by ultrasonography. Oocyte recovery, then fertilization and embryo culture were done. A significant higher level in the number of mature and fertilized oocytes was in group III, followed by group II. The rate of fertilization and normally cleaved embryos was higher in groups monitored by both ultrasonography and estradiol level. There was a fair association between the number of mature and fertilized oocytes and between serum estradiol on the day of HCG administration and number of fertilized oocytes