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

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.

Chinese abstract

有研究对宫内人工授精 (IUI) 中应用GnRH拮抗剂对控制性卵巢刺激 (COS) 的有效性提出争议。本研究使用一半常规剂量的GnRH拮抗剂西曲瑞克评估其是否有效增加IUI周期的成功率。患者在月经周期的第三天开始使用人绝经后促性腺激素 (hMG) 进行控制性卵巢刺激。当在超声下检测到至少一个≥14mm的卵泡时, 开始西曲瑞克治疗, 日给药剂量采用灵活方案, 持续治疗至重组人绒毛膜促性腺激素 (hCG) 的触发日。使用低剂量GnRH拮抗剂治疗的患者的妊娠率 (21.7%) 显著高于单纯hMG治疗的患者的妊娠率 (8.7%), 二者相比差异有统计学意义 (p＜0.05) 。这些结果表明, 在宫内人工授精 (IUI) 的控制性卵巢刺激 (COS) 中采用低剂量的GnRH拮抗剂可显著提高妊娠率。

Keywords:

• Cetrorelix
• controlled ovarian stimulation
• GnRH antagonist
• human menopausal gonadotropin
• intrauterine insemination

Declaration of interest

The authors report no conflicts of interest.