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Hum. Reprod. Advance Access originally published online on July 18, 2007
Human Reproduction 2007 22(10):2795; doi:10.1093/humrep/dem233
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Letters to the Editor

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

Niraj N. Mahajan1,3, Kshitija N. Mahajan2 and Rajani N. Soni1

1 Department of Obstetrics and Gynaecology, Padhar Hospital, Padhar, Betul District, Madhya Pradesh 460005, India 2 Department of Anaesthesiology, Padhar Hospital, Padhar, Betul District, Madhya Pradesh 460005, India

3 Correspondence address. Tel: +91-7141263046; Fax: +91-7141263346; E-mail: nirajdr{at}hotmail.com

Sir,

We read with interest the paper by Crosignani et al. (2007)Go on effect of GnRH antagonists in mildly stimulated intrauterine insemination (IUI) cycles and agree with the authors that, further large studies and meta-analyses are required to determine the effects of GnRH antagonist in mild controlled ovarian hyperstimulation (COH). We have the following comments:

  1. The authors in their study used single IUI. Double IUI increases the pregnancy rate significantly compared with single IUI in COH (Matilsky et al., 1998Go; Ragni et al., 1999Go; Liu et al., 2006Go). Perhaps when estradiol (E2) levels are at threshold for multiple pregnancies (MP), one-day IUI cycles can be considered to reduce the risk of MP instead of cancelling the cycle.
  2. ‘Soft’ stimulation protocols for COH are gaining in popularity these days to prevent MP. COH with clomiphene citrate and gonadotropins (Ragni et al., 1999Go) is another option for COH, which is cost effective also.
  3. We would ask the authors to kindly comment on what the other possibilities are if E2 levels are beyond the stated threshold level for MP, apart from cancelling the cycle to achieve single pregnancy?

We hope further discussion and suggestions will contribute to the advancement and popularity of the author's findings.

References

Crosignani PG, Somigliana E, Intrauterine Insemination Study Group. Effect of GnRH antagonists in FSH mildly stimulated intrauterine insemination cycles: a multicentre randomized trial. Hum Reprod (2007) 22:500–505.[Abstract/Free Full Text]

Liu W, Gong F, Luo K, Lu G. Comparing the pregnancy rates of one versus two intrauterine inseminations (IUIs) in male factor and idiopathic infertility. J Assist Reprod Genet (2006) 23:75–79.[CrossRef][Web of Science][Medline]

Matilsky M, Geslevich Y, Ben-Ami M, Ben-Shlomo I, Weiner-Megnagi T, Shalev E. Two-day IUI treatment cycles are more successful than one-day IUI cycles when using frozen-thawed donor sperm. J Androl (1998) 19:603–607.[Abstract/Free Full Text]

Ragni G, Maggioni P, Guermandi E, Testa A, Baroni E, Colombo M, Crosignani PG. Efficacy of double intrauterine insemination in controlled ovarian hyperstimulation cycles. Fertil Steril (1999) 72:619–622.[CrossRef][Web of Science][Medline]


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This Article
Right arrow Extract Freely available
Right arrow FREE Full Text (PDF ) Freely available
Right arrow All Versions of this Article:
22/10/2795    most recent
dem233v1
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Google Scholar
Right arrow Articles by Mahajan, N. N.
Right arrow Articles by Soni, R. N.
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PubMed
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Right arrow Articles by Mahajan, N. N.
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