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Use of gonadotropin-releasing hormone antagonists to overcome the drawbacks of intrauterine insemination on weekends.
Fertil Steril. 2006 Mar; 85(3):573-7.FS

Abstract

OBJECTIVE

To assess the usefulness of the GnRH antagonist cetrorelix to prevent LH surge and to avoid intrauterine insemination at weekends when a gynecologist on duty is not available and the ultrasound scan on Friday showed > 1 and < 3 follicles > or = 17 mm in diameter.

DESIGN

Open-label, randomized, prospective study.

SETTING

Reproductive medicine unit in an acute care teaching hospital in Barcelona, Spain.

PATIENT(S)

Infertile patients undergoing controlled ovarian hyperstimulation (COH) and IUI.

INTERVENTION(S)

Treatment with recombinant FSH was started on day 3. In women assigned to the control group (n = 32), recombinant FSH was continued up to the day of hCG administration. In patients assigned to the GnRH antagonist group (n = 35), half of the dose of recombinant FSH was given for 2 more days in addition to cetrorelix (0.25 mg SC) until the day of hCG administration.

MAIN OUTCOME MEASURE(S)

Recombinant FSH doses, E(2) level on the day of hCG administration, number and diameter of follicles, endometrial thickness, and number of pregnancies.

RESULT(S)

Only a case of premature ovulation occurred in the cetrorelix group. There were no significant differences between the study groups in the total mean number of follicles, follicles > 10 mm and < 17 mm, and follicles > or = 17 mm. The mean concentration of E2 on the day of hCG administration and the endometrial thickness were significantly higher in the cetrorelix group. Eleven pregnancies were achieved, 7 (20%) in the cetrorelix group (4 singleton, 3 twins) and 4 (12.5%) in controls (4 singleton). No case of ovarian hyperstimulation syndrome (OHSS) occurred.

CONCLUSION(S)

The use of cetrorelix to avoid IUI at weekends when the ultrasound scan on Friday shows > 1 and < 3 follicles > or = 17 mm is a useful alternative for medical centers in which a gynecologist on call is not available.

Authors+Show Affiliations

Service of Obstetrics and Gynecology, Hospital Universitari del Mar, Universitat Autónoma de Barcelona, Barcelona, Spain. MAcheca@imas.imim.esNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16500321

Citation

Checa, Miguel A., et al. "Use of Gonadotropin-releasing Hormone Antagonists to Overcome the Drawbacks of Intrauterine Insemination On Weekends." Fertility and Sterility, vol. 85, no. 3, 2006, pp. 573-7.
Checa MA, Prat M, Robles A, et al. Use of gonadotropin-releasing hormone antagonists to overcome the drawbacks of intrauterine insemination on weekends. Fertil Steril. 2006;85(3):573-7.
Checa, M. A., Prat, M., Robles, A., & Carreras, R. (2006). Use of gonadotropin-releasing hormone antagonists to overcome the drawbacks of intrauterine insemination on weekends. Fertility and Sterility, 85(3), 573-7.
Checa MA, et al. Use of Gonadotropin-releasing Hormone Antagonists to Overcome the Drawbacks of Intrauterine Insemination On Weekends. Fertil Steril. 2006;85(3):573-7. PubMed PMID: 16500321.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of gonadotropin-releasing hormone antagonists to overcome the drawbacks of intrauterine insemination on weekends. AU - Checa,Miguel A, AU - Prat,María, AU - Robles,Ana, AU - Carreras,Ramón, PY - 2005/01/07/received PY - 2005/08/23/revised PY - 2005/08/23/accepted PY - 2006/2/28/pubmed PY - 2006/3/22/medline PY - 2006/2/28/entrez SP - 573 EP - 7 JF - Fertility and sterility JO - Fertil. Steril. VL - 85 IS - 3 N2 - OBJECTIVE: To assess the usefulness of the GnRH antagonist cetrorelix to prevent LH surge and to avoid intrauterine insemination at weekends when a gynecologist on duty is not available and the ultrasound scan on Friday showed > 1 and < 3 follicles > or = 17 mm in diameter. DESIGN: Open-label, randomized, prospective study. SETTING: Reproductive medicine unit in an acute care teaching hospital in Barcelona, Spain. PATIENT(S): Infertile patients undergoing controlled ovarian hyperstimulation (COH) and IUI. INTERVENTION(S): Treatment with recombinant FSH was started on day 3. In women assigned to the control group (n = 32), recombinant FSH was continued up to the day of hCG administration. In patients assigned to the GnRH antagonist group (n = 35), half of the dose of recombinant FSH was given for 2 more days in addition to cetrorelix (0.25 mg SC) until the day of hCG administration. MAIN OUTCOME MEASURE(S): Recombinant FSH doses, E(2) level on the day of hCG administration, number and diameter of follicles, endometrial thickness, and number of pregnancies. RESULT(S): Only a case of premature ovulation occurred in the cetrorelix group. There were no significant differences between the study groups in the total mean number of follicles, follicles > 10 mm and < 17 mm, and follicles > or = 17 mm. The mean concentration of E2 on the day of hCG administration and the endometrial thickness were significantly higher in the cetrorelix group. Eleven pregnancies were achieved, 7 (20%) in the cetrorelix group (4 singleton, 3 twins) and 4 (12.5%) in controls (4 singleton). No case of ovarian hyperstimulation syndrome (OHSS) occurred. CONCLUSION(S): The use of cetrorelix to avoid IUI at weekends when the ultrasound scan on Friday shows > 1 and < 3 follicles > or = 17 mm is a useful alternative for medical centers in which a gynecologist on call is not available. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/16500321/Use_of_gonadotropin_releasing_hormone_antagonists_to_overcome_the_drawbacks_of_intrauterine_insemination_on_weekends_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(05)03969-5 DB - PRIME DP - Unbound Medicine ER -