Use of gonadotropin-releasing hormone antagonists to overcome the drawbacks of intrauterine insemination on weekends

Miguel A. Checa, María Prat, Ana Robles, Ramón Carreras

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30 Citations (Scopus)

Abstract

Objective: To assess the usefulness of the GnRH antagonist cetrorelix to prevent LH surge and to avoid intrauterine insemination at weekends when a gynecologist on duty is not available and the ultrasound scan on Friday showed >1 and <3 follicles ≥17 mm in diameter. Design: Open-label, randomized, prospective study. Setting: Reproductive medicine unit in an acute care teaching hospital in Barcelona, Spain. Patient(s): Infertile patients undergoing controlled ovarian hyperstimulation (COH) and IUI. Intervention(s): Treatment with recombinant FSH was started on day 3. In women assigned to the control group (n = 32), recombinant FSH was continued up to the day of hCG administration. In patients assigned to the GnRH antagonist group (n = 35), half of the dose of recombinant FSH was given for 2 more days in addition to cetrorelix (0.25 mg SC) until the day of hCG administration. Main Outcome Measure(s): Recombinant FSH doses, E2 level on the day of hCG administration, number and diameter of follicles, endometrial thickness, and number of pregnancies. Result(s): Only a case of premature ovulation occurred in the cetrorelix group. There were no significant differences between the study groups in the total mean number of follicles, follicles >10 mm and <17 mm, and follicles ≥17 mm. The mean concentration of E2 on the day of hCG administration and the endometrial thickness were significantly higher in the cetrorelix group. Eleven pregnancies were achieved, 7 (20%) in the cetrorelix group (4 singleton, 3 twins) and 4 (12.5%) in controls (4 singleton). No case of ovarian hyperstimulation syndrome (OHSS) occurred. Conclusion(s): The use of cetrorelix to avoid IUI at weekends when the ultrasound scan on Friday shows >1 and <3 follicles ≥17 mm is a useful alternative for medical centers in which a gynecologist on call is not available. ©2006 by American Society for Reproductive Medicine.
Original languageEnglish
Pages (from-to)573-577
JournalFertility and Sterility
Volume85
Issue number3
DOIs
Publication statusPublished - 1 Mar 2006

Keywords

  • Cetrorelix
  • GnRH antagonists
  • Intrauterine insemination
  • LH surge

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