Gonadotropin-releasing hormone agonist improves the efficiency of controlled ovarian hyperstimulation/intrauterine insemination

Carol L. Gagliardi, C L Gagliardi, Adelina M. Emmi, A M Emmi, Gerson Weiss, G Weiss, Cecilia L. Schmidt, C L Schmidt
Fertility and sterility · 1991 · vol. 55(5) , pp. 939–944 · doi:10.1016/s0015-0282(16)54303-9 · PMID:1902421 · W2465144380
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This study investigated whether a gonadotropin-releasing hormone agonist improves the efficiency of controlled ovarian hyperstimulation combined with intrauterine insemination.

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Abstract

OBJECTIVE: Leuprolide acetate (LA) has improved the efficiency of human menopausal gonadotropins (hMG) in in vitro fertilization cycles. We hypothesized that the combination of LA/hMG/intrauterine insemination (IUI) would be more efficacious than hMG/IUI cycles. DESIGN: During an 18-month period, all patients completing either a hMG/IUI cycle (group I) or a LA/hMG/IUI cycle (group II) had the characteristics and outcomes of their stimulation cycles assessed. The groups were not prospectively randomized. SETTING: Referral center at a tertiary care hospital. PATIENTS: One hundred twenty three patients in group I completed 219 cycles, and 64 patients in group II completed 102 cycles. Twenty-eight of the patients who failed to conceive with hMG/IUI were advanced to group II. MAIN OUTCOME MEASURES: Pregnancy/IUI is compared between the two groups. RESULTS: Group II demonstrated significantly greater clinical pregnancy/IUI than group I (26.5% and 16.0%, respectively, P less than 0.05), as well as a higher live birth/IUI (21.6% and 12.8%, respectively, P less than 0.05). No difference was present in the rate of fetal wastage or multiple births. CONCLUSIONS: In our patients with recalcitrant infertility, the addition of a gonadotropin-releasing hormone agonist to hMG/IUI improved the pregnancy rate, without increasing the rate of multiple births or fetal wastage.

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MeSH descriptors

Gonadotropin-Releasing Hormone Insemination, Artificial Menotropins Ovary Female Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Humans Infertility Infertility Infertility Insemination, Artificial Leuprolide Male Menotropins Menotropins Ovary Pregnancy Pregnancy, Multiple

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