Effect of GnRH antagonists in FSH mildly stimulated intrauterine insemination cycles: a multicentre randomized trial.

Full Abstract

BACKGROUND:
The usefulness of GnRH antagonists in mild controlled ovarian hyperstimulation (COH) and intrauterine insemination (IUI) cycles is debated.

METHODS:
Two-hundred and ninety-nine couples with unexplained or mild male factor infertility were enrolled in this international multicentre randomized controlled trial. Women allocated to the GnRH antagonist group (n=148) received 50 IU recombinant FSH starting on day 3 of the menstrual cycle and Ganirelix 0.25 mg daily starting from the day in which a follicle with a mean diameter of 13-14 mm was visualized at ultrasound. Women allocated to the control group (n=151) were administered only 50 IU recombinant FSH starting on day 3 of the menstrual cycle. Couples were recruited only for their first treatment cycle. The primary outcome was the clinical pregnancy rate per initiated cycle.

RESULTS:
Baseline characteristics of the two treatment groups were similar. Clinical pregnancy rates per initiated cycle in women who did and did not receive GnRH antagonists were 12.2 and 12.6%, respectively (P=1.00). The relative risk of conception (95% confidence interval) for the use of GnRH antagonists was 1.0 (0.5-1.9).

CONCLUSIONS:
In mild COH and IUI cycles, any benefit of the use of GnRH antagonists in improving pregnancy rates is <2-fold increase.

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Author information

Author/s: Crosignani, P G (PG); Somigliana, E (E); Intrauterine Insemination Study Group;

Affiliation: Department of Obstetrics and Gynecology II, Università degli Studi di Milano, Milano, Italy. piergiorgio.crosignani(-atsign-)unimi.it

Journal and publication information

Publication Type: Journal Article; Multicenter Study; Randomized Controlled Trial

Journal: Human reproduction (Oxford, England) (Hum Reprod), published in England. (Language: eng)

Reference: 2007-Feb; vol 22 (issue 2) : pp 500-5

Dates: Created 2007/01/11; Completed 2007/03/16; Revised 2007/12/06;

PMID: 17062582, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Hum Reprod. 2007 Oct;22(10):2795; author reply 2796. (PMID: 17636275)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Female
Follicle Stimulating Hormone - pharmacology
Gonadotropin-Releasing Hormone - analogs & derivatives; antagonists & inhibitors; pharmacology
Humans

Humans
Insemination, Artificial - methods
Ovulation Induction - methods
Pregnancy
Pregnancy Rate

Associated Chemicals: ganirelix (123246-29-7) ; Gonadotropin-Releasing Hormone (33515-09-2) ; Follicle Stimulating Hormone (9002-68-0)

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