GnRH antagonists and mild ovarian stimulation for intrauterine insemination: a randomized study comparing different gonadotrophin dosages

Ragni, G.; Alagna, Federica; Brigante, Claudio; Riccaboni, A.; Colombo, M.; Somigliana, Edgardo; Crosignani, Pier Giorgio

doi:10.1093/humrep/deh023

Cited by 45 publications

(27 citation statements)

References 21 publications

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“…Research has shown that in stimulated IUI cycles spontaneous LH surges occur frequently in upto one-third of all cycles resulting in higher cycle cancellation rates and lower pregnancy rates [6]. Our study demonstrates that treatment with GnRH antagonist (cetrorelix) significantly reduces premature LH surge, progesterone rises and premature luteinisation.…”

Section: Mild Ovarian Hyperstimulation (Moh) Is Defined As the Adminisupporting

confidence: 51%

“…Still other studies conducted by Williams et al [15] and Ragni et al [6] did not find any significant differences in regard to pregnancy rates between patients treated with rFSH ? GnRH antagonist or rFSH alone.…”

Section: Mild Ovarian Hyperstimulation (Moh) Is Defined As the Adminimentioning

confidence: 75%

“…One patient in group A (2.9 %) and two patients (5.6 %) in group B had mild OHSS and were excluded from the study. This difference is statistically insignificant with p value of 1.000. oral compounds (like anti-estrogens or aromatase inhibitors) along with gonadotropins for ovarian stimulation, aiming to limit the number of oocytes obtained less than eight [6,7]. MOH when used in combination with IUI improves the pregnancy outcome.…”

Section: Resultsmentioning

confidence: 99%

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Evaluation of Role of GnRH Antagonist in Intrauterine Insemination (IUI) Cycles with Mild Ovarian Hyperstimulation (MOH): A Prospective Randomised Study

Wadhwa

Khanna

Gupta

et al. 2016

J Obstet Gynecol India

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Aims and Objective To evaluate the role of GnRH antagonist in prevention of premature LH surge and increasing pregnancy rates in IUI cycle with mild ovarian hyperstimulation (MOH). Study Design Prospective parallel, randomised controlled study. Material and Methods Couples diagnosed with unexplained, male factor subfertility and with one or both tubes patent were randomised to receive either a GnRH antagonist (study group) or no intervention (control group 123 women were treated with clomiphene citrate (D3-D7) followed by HMG. A GnRH antagonist was added when one or more follicles of 16 mm diameter or more were visualised in the study group. When at least one follicle reached a size of C18 mm, ovulation was induced by hCG injection. A single IUI was performed 36 h later. The primary outcome was premature LH surge and pregnancy rate. The secondary outcomes were the amount of gonadotropins used, duration of use of GnRH antagonist and incidence and severity of OHSS. Results A total of seventy patients attending the infertility clinic in the outpatient department of Obstetrics and Gynecology, of a tertiary care centre, were recruited in the study which was carried out from August 2011 to March 2013. The study group included 34 women and 36 in the control arm. The incidence of premature LH surge was significantly lower in the antagonist group as compared to the control group 2.9 vs. 13.9 %, with a p value of \0.001. The clinical pregnancy rates were similar in both the groups 8.8 vs. 11.1 %, p value being 1.000. The amount of gonadotropins used in GnRH antagonist group was lower than in control group but not statistically significant. Duration of GnRH antagonist was 1.85 ± 0.61 days in the study group. Conclusion The delayed administration of GnRH antagonists in MOH with IUI cycles when follicle size is C16 mm is beneficial in terms of preventing the occurrence of premature LH surge but with no improvement in pregnancy rates.

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Section: Mild Ovarian Hyperstimulation (Moh) Is Defined As the Adminisupporting

confidence: 51%

Section: Mild Ovarian Hyperstimulation (Moh) Is Defined As the Adminimentioning

confidence: 75%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of Role of GnRH Antagonist in Intrauterine Insemination (IUI) Cycles with Mild Ovarian Hyperstimulation (MOH): A Prospective Randomised Study

Wadhwa

Khanna

Gupta

et al. 2016

J Obstet Gynecol India

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“…Ragni et al reported that the daily use of 50 IU of rFSH, combined with a GnRH antagonist, ganirelix, for ovarian stimulation prior to IUI resulted in a live birth rate per couple of 25.7%. 13 When the same dose of rFSH was used on alternate days, rFSH produced a live birth rate of 2.9%. 13 In another study, 50 IU daily of rFSH was found similar to 75 IU daily of urinary FSH (uFSH) in the outcomes of the number of follicles >17 mm and days of stimulation.…”

Section: Educationmentioning

confidence: 99%

“…13 When the same dose of rFSH was used on alternate days, rFSH produced a live birth rate of 2.9%. 13 In another study, 50 IU daily of rFSH was found similar to 75 IU daily of urinary FSH (uFSH) in the outcomes of the number of follicles >17 mm and days of stimulation. 14 The clinical pregnancy rates were 12.7% for rFSH and 11.9% for uFSH.…”

Section: Educationmentioning

confidence: 99%

Study of Intrauterine Insemination (IUI) among 52 Cases in a Newly Established Infertility Care Centre of Dhaka Medical College Hospital

Rahman

Kutubi

Jabeen

et al. 2018

J Shaheed Suhrawardy Med Coll

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Intra-uterine insemination for male subfertility

Bensdorp

Cohlen

Heineman

et al. 2007

Cochrane Database of Systematic Reviews

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GnRH antagonists and mild ovarian stimulation for intrauterine insemination: a randomized study comparing different gonadotrophin dosages

Abstract: A protocol of recombinant FSH 50 IU daily and GnRH antagonist may represent an effective and safe regimen for ovulation induction associated with intrauterine insemination.

Cited by 45 publications

References 21 publications

Evaluation of Role of GnRH Antagonist in Intrauterine Insemination (IUI) Cycles with Mild Ovarian Hyperstimulation (MOH): A Prospective Randomised Study

Evaluation of Role of GnRH Antagonist in Intrauterine Insemination (IUI) Cycles with Mild Ovarian Hyperstimulation (MOH): A Prospective Randomised Study

Study of Intrauterine Insemination (IUI) among 52 Cases in a Newly Established Infertility Care Centre of Dhaka Medical College Hospital

Intra-uterine insemination for male subfertility

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