Clinical experience with an ovarian stimulation protocol for intrauterine insemination adopting a gonadotropin releasing hormone antagonist at low dose

Gynecol Endocrinol. 2017 Mar;33(3):208-211. doi: 10.1080/09513590.2016.1252327. Epub 2016 Dec 6.

Abstract

Studies testing the effectiveness of GnRH antagonists in controlled ovarian stimulation (COS) for intrauterine insemination (IUI) have provided controversial results. The present study was undertaken to evaluate, whether the use of a half of the conventional dose of the GnRH antagonist cetrorelix can be effective in increasing the successful rate of IUI cycles. Patients started COS with human menopausal gonadotropin (hMG) on day three of the menstrual cycle. Cetrorelix was started when at least one follicle of ≥14 mm, was detected at the ultrasound scan, according to the flexible multiple daily dose protocol, and continued until the trigger day with recombinant hCG. Patients adopting GnRH antagonist at low dose had a pregnancy rate (21.7%) that was significantly higher (p < 0.05) in comparison to women receiving hMG only (8.7%). These results suggest that adding a reduced dose of GnRH antagonist to the COS for IUI cycles significantly improves the outcome of the procedure.

Keywords: Cetrorelix; GnRH antagonist; controlled ovarian stimulation; human menopausal gonadotropin; intrauterine insemination.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Chorionic Gonadotropin / genetics
  • Chorionic Gonadotropin / metabolism
  • Chorionic Gonadotropin / therapeutic use
  • Female
  • Fertility Agents, Female / administration & dosage*
  • Fertility Agents, Female / therapeutic use
  • Gonadotropin-Releasing Hormone / administration & dosage
  • Gonadotropin-Releasing Hormone / analogs & derivatives*
  • Gonadotropin-Releasing Hormone / antagonists & inhibitors*
  • Gonadotropin-Releasing Hormone / therapeutic use
  • Hormone Antagonists / administration & dosage*
  • Hormone Antagonists / therapeutic use
  • Hospitals, University
  • Humans
  • Infertility, Female / therapy*
  • Infertility, Male
  • Insemination, Artificial*
  • Italy
  • Male
  • Menotropins / therapeutic use
  • Ovulation / drug effects
  • Ovulation Induction*
  • Pregnancy
  • Pregnancy Rate
  • Recombinant Proteins / therapeutic use

Substances

  • Chorionic Gonadotropin
  • Fertility Agents, Female
  • Hormone Antagonists
  • Recombinant Proteins
  • Gonadotropin-Releasing Hormone
  • Menotropins
  • cetrorelix