Pregnancy rate after ovulation triggering with gonadotrophin releasing hormone agonist versus human chorionic gonadotrophin in women undergoing controlled ovarian stimulation/intrauterine insemination

Abstract

Background: GnRHa is as effective as hCG for ovulation triggering, apart from LH surge, FSH surge is also induced. Objective: To compare triggering of ovulation by inducing endogenous LH surge (GnRHa) or using hCG in hMG stimulated cycles for intrauterine insemination (IUI). Setting: Prospective randomized study. Materials and methods: Out of the three hundred and eighty patients scheduled for IUI, after exclusion of 28 women, 352 were assigned to two groups: hMG/GnRHa (study group, n = 176) were assigned for receiving HP hMG followed by triggering by GnRHa and hMG/hCG (control group, n = 176) were assigned for HP hMG followed by hCG for ovulation triggering. Intrauterine insemination was done using freshly prepared semen 36 h after triggering of ovulation. Luteal phase support was done by 1500 IU hCG, 12 h after the triggering of ovulation. Results: LH levels significantly (p < 0.001) increased in the hMG/GnRHa group than in the hMG/hCG group. No significant differences were seen between the basal LH, progesterone levels before and 8 days after triggering in both groups. The duration of the luteal phase was similar in both groups. Pregnancy rates per cycle were 17.61% for GnRHa and 13.06% for hCG respectively (p = 0.23). Conclusions: There is no difference between GnRHa and hCG as regards pregnancy rate in women undergoing hMG stimulation for IUI cycles.

Keywords

• GnRH agonist
• Ovulation triggering
• IUI
• Pregnancy rate