This is a review of the NEJM Paper: AMIGOS: Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation

The AMIGOS trial was a multicenter, randomized clinical trial that evaluated the safety and efficacy of different methods of ovulation induction in women undergoing in vitro fertilization (IVF). The study was conducted between 2012 and 2016 in 12 clinical centers across the United States.

The primary objective of the study was to compare the rates of live births for three different methods of ovulation induction: clomiphene citrate, letrozole, and gonadotropins. The study also evaluated other outcomes such as multiple gestations, ovarian hyperstimulation syndrome, and congenital anomalies.

The study included 1,085 women between the ages of 18 and 42 years who were undergoing IVF. The participants were randomly assigned to receive one of the three different methods of ovulation induction. The study's primary outcome was live birth rate per ovulation cycle.

The results of the study showed that the rates of live births were similar across the three groups. However, the incidence of multiple gestations was significantly lower in the clomiphene citrate and letrozole groups compared to the gonadotropin group. The incidence of ovarian hyperstimulation syndrome was also significantly lower in the clomiphene citrate group compared to the other two groups.

Overall, the AMIGOS trial provides evidence that clomiphene citrate and letrozole may be safer and more effective than gonadotropins for ovulation induction in women undergoing IVF. The study's findings have implications for the management of infertility and the use of different methods of ovulation induction in clinical practice.

Diamond et al., (2015): [ Ссылка ]

Diamond et al., (2011): [ Ссылка ]

infertility, in vitro fertilization, gonadotropins, congenital anomalies

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