The use of gonadotropin-releasing hormone antagonist in women undergoing intrauterine insemination

Abstract

Background Intrauterine insemination (IUI) is considered to be a very popular treatment procedure that is used for many infertile women worldwide. Aim The aim was to evaluate whether the addition of gonadotropin-releasing hormone antagonist would improve the clinical pregnancy rate in women undergoing IUI. Materials and methods A prospective study was performed at El-Galaa Maternity Teaching Hospital where 124 women with primary or secondary infertility were subjected to controlled ovarian stimulation with human menopausal gonadotropin (74–150 IU/day) only (control group, n=62) or to human menopausal gonadotropin (75–150 IU/day) plus Cetrorelix (0.25 mg/day, starting when the leading follicle was ≥16 mm; n=62). A single insemination was performed 36 h after hCG was given (5,000 IU, intramuscularly) in both groups. Main outcome measure(s) Clinical pregnancy rate, premature luteinization (PL), and follicular development were measured. Results Clinical pregnancy rates (20 vs10.9%) and the number of mature follicles (2.2±1.1 vs 1.4±0.96) were statistically significantly higher in the antagonist group compared with the control group. The PL rate was significantly lower in the antagonist group (0.91 vs 4.61%). Conclusion The addition of a gonadotropin-releasing hormone antagonist to controlled ovarian stimulation and IUI was significantly associated with an increase in pregnancy rates in multifollicular cycles and a reduction in the incidence of PL.

Keywords

• gonadotropin-releasing hormone antagonist
• intrauterine insemination
• ovarian stimulation
• pregnancy rates