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Multifollicular recruitment in combination with gonadotropin-releasing hormone antagonist increased pregnancy rates in intrauterine insemination cycles.
Fertil Steril. 2008 Mar; 89(3):620-4.FS

Abstract

OBJECTIVE

To determine whether including a GnRH antagonist in controlled ovarian stimulation-intrauterine insemination cycles would increase pregnancy rates.

DESIGN

Prospective randomized study.

SETTING

Private reproductive medicine clinic in Spain.

PATIENT(S)

Three hundred sixty-seven women with primary or secondary infertility.

INTERVENTION(S)

Patients were randomly assigned to controlled ovarian stimulation with recombinant FSH (75-150 IU/d) alone (controls, n = 183) or with recombinant FSH (75-150 IU/d) + the GnRH antagonist (0.25 mg/d), initiated when the recruited follicles were >or=16 mm (n = 184). A single insemination was performed, 36-38 hours after hCG (5,000 IU, IM), in both groups.

MAIN OUTCOME MEASURE(S)

Follicular recruitment, pregnancy rates.

RESULT(S)

Numbers of mature follicles (2.4 +/- 1.3 vs. 1.3 +/- 1.09) and clinical pregnancy rates (23% vs. 11%) were statistically significantly higher in patients who were treated with GnRH antagonist than in those who were in the control group. The pregnancy rate was only higher in the antagonist group if more than one follicle sized >or=18 mm was present on the day that the hCG was given. A similar number of twin pregnancies occurred in both groups: two in the antagonist group and three in the control group. The antagonist group also had one triplet gestation.

CONCLUSION(S)

Adding GnRH antagonist to controlled ovarian stimulation-intrauterine insemination cycles significantly increases pregnancy rates in multifollicular, but not monofollicular, cycles.

Authors+Show Affiliations

Clínica de Medicina de la Reproducción y Ginecología FivMadrid, Madrid, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17678911

Citation

Gómez-Palomares, Jose Luis, et al. "Multifollicular Recruitment in Combination With Gonadotropin-releasing Hormone Antagonist Increased Pregnancy Rates in Intrauterine Insemination Cycles." Fertility and Sterility, vol. 89, no. 3, 2008, pp. 620-4.
Gómez-Palomares JL, Acevedo-Martín B, Chávez M, et al. Multifollicular recruitment in combination with gonadotropin-releasing hormone antagonist increased pregnancy rates in intrauterine insemination cycles. Fertil Steril. 2008;89(3):620-4.
Gómez-Palomares, J. L., Acevedo-Martín, B., Chávez, M., Manzanares, M., Ricciarelli, E., & Hernández, E. R. (2008). Multifollicular recruitment in combination with gonadotropin-releasing hormone antagonist increased pregnancy rates in intrauterine insemination cycles. Fertility and Sterility, 89(3), 620-4.
Gómez-Palomares JL, et al. Multifollicular Recruitment in Combination With Gonadotropin-releasing Hormone Antagonist Increased Pregnancy Rates in Intrauterine Insemination Cycles. Fertil Steril. 2008;89(3):620-4. PubMed PMID: 17678911.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Multifollicular recruitment in combination with gonadotropin-releasing hormone antagonist increased pregnancy rates in intrauterine insemination cycles. AU - Gómez-Palomares,Jose Luis, AU - Acevedo-Martín,Belén, AU - Chávez,Marián, AU - Manzanares,M Angeles, AU - Ricciarelli,Elisabetta, AU - Hernández,Eleuterio R, Y1 - 2007/08/06/ PY - 2007/01/16/received PY - 2007/03/12/revised PY - 2007/03/12/accepted PY - 2007/8/7/pubmed PY - 2008/3/28/medline PY - 2007/8/7/entrez SP - 620 EP - 4 JF - Fertility and sterility JO - Fertil. Steril. VL - 89 IS - 3 N2 - OBJECTIVE: To determine whether including a GnRH antagonist in controlled ovarian stimulation-intrauterine insemination cycles would increase pregnancy rates. DESIGN: Prospective randomized study. SETTING: Private reproductive medicine clinic in Spain. PATIENT(S): Three hundred sixty-seven women with primary or secondary infertility. INTERVENTION(S): Patients were randomly assigned to controlled ovarian stimulation with recombinant FSH (75-150 IU/d) alone (controls, n = 183) or with recombinant FSH (75-150 IU/d) + the GnRH antagonist (0.25 mg/d), initiated when the recruited follicles were >or=16 mm (n = 184). A single insemination was performed, 36-38 hours after hCG (5,000 IU, IM), in both groups. MAIN OUTCOME MEASURE(S): Follicular recruitment, pregnancy rates. RESULT(S): Numbers of mature follicles (2.4 +/- 1.3 vs. 1.3 +/- 1.09) and clinical pregnancy rates (23% vs. 11%) were statistically significantly higher in patients who were treated with GnRH antagonist than in those who were in the control group. The pregnancy rate was only higher in the antagonist group if more than one follicle sized >or=18 mm was present on the day that the hCG was given. A similar number of twin pregnancies occurred in both groups: two in the antagonist group and three in the control group. The antagonist group also had one triplet gestation. CONCLUSION(S): Adding GnRH antagonist to controlled ovarian stimulation-intrauterine insemination cycles significantly increases pregnancy rates in multifollicular, but not monofollicular, cycles. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/17678911/Multifollicular_recruitment_in_combination_with_gonadotropin_releasing_hormone_antagonist_increased_pregnancy_rates_in_intrauterine_insemination_cycles_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(07)00654-1 DB - PRIME DP - Unbound Medicine ER -