Hum. Reprod. Advance Access originally published online on October 24, 2006
Human Reproduction 2007 22(2):500-505; doi:10.1093/humrep/del416
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Effect of GnRH antagonists in FSH mildly stimulated intrauterine insemination cycles: a multicentre randomized trial
1 Università degli Studi di Milano and 2 Infertility Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy
3 To whom correspondence should be addressed at: Department of Obstetrics and Gynecology II, Università degli Studi di Milano, Via Commenda 12-20122, Milano, Italy. E-mail: piergiorgio.crosignani{at}unimi.it
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.
Key words: intrauterine insemination/mild ovarian hyperstimulation/GnRH antagonist
* M.A.Aboulghar, The Egyptian IVF-ET Center, Cairo, Egypt; A.Allegra, Reproductive Medicine Unit, ANDROS Day Surgery, Palermo, Italy; R.Buxaderas, Reproductive Medicine Service, Institut Universitari Dexeus, Barcelona, Spain; V.Forgacs, Forgacs Institute of Assisted Reproduction, Budapest, Hungary; G.Griesinger, Department of Obstetrics-Gynaecology, University Clinic of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany; R.Homburg, Division of Reproductive Medicine, Vrije Universiteit Medical Center, Amsterdam, The Netherlands; M.Hrehorcak, Center of Reproductive Medicine and Reproductive Genetics, 2nd Medical Faculty, Charles University, Prague, Czech Republic; J.Konc, Infertility and IVF Center of Buda, St. John’s Hospital, Budapest, Hungary; L.Mamas, Neogenesis, IVF Center, Athens, Greece; G.Ragni, Infertility Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy; V.Silhan, Center of Assisted Reproduction SANUS, Hradec Kralove, Czech Republic.
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P. G. Crosignani and E. Somigliana Reply: Effect of GnRH antagonists in FSH mildly stimulated intrauterine insemination cycles: a multicentre randomized trial Hum. Reprod., October 1, 2007; 22(10): 2796 - 2796. [Full Text] [PDF]
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