The Use of Gonadotropin Releasing Hormone Antagonist in Women Undergoing Intrauterine Insemination

Background: Intrauterine insemination (IUI) is considered to be a very popular treatment procedure that is used for many infertile women worldwide. The aim of this study is to evaluate whether the addition of gonadotropin releasing hormone antagonist would improve the clinical pregnancy rate in women undergoing IUI. Methods: A prospective study performed at El-Galaa Maternity Teaching Hospital where 124 women suffering from primary or secondary infertility were subjected to controlled ovarian stimulation (COS) with hMG (human menopausal gonadotropin) (74 to 150 IU/d) only (control group, n 62) or to hMG (75 to 150 IU/d) plus Cetrotide (0.25 mg/d, starting when the leading follicle was ≥ 16 mm; n 62). A single insemination was performed 36 hours after hCG was given (5,000 IU, IM) in both groups. Main Outcome Measure: Clinical pregnancy rate, premature luteinization and follicular development. Result: Clinical pregnancy rates (20% vs. 10.9%), and the number of mature follicles (2.2 ± 1.1 vs. 1.4 ± 0.96) were statistically significantly higher in the antagonist group compared with the control group. The premature luteinization rate was significantly lower in the antagonist group (0.91% vs. 4.61%). Conclusion: The addition of a GnRH antagonist to controlled ovarian stimulation and IUI was significantly associated with an increase in pregnancy rates in multifollicular cycles and a reduction in the incidence of premature luteinization.