Study of Positive and Negative Consequences of Using GnRH Antagonist in Intrauterine Insemination Cycles

Background: To assess the usefulness of premature luteinization hormone (LH) surge prevention in an intrauterine insemination (IUI) cycle by GnRH antagonist administration. Materials and Methods: Sixty patients with unexplained or mild male infertility or minimal to mild endometriosis were enrolled in this prospective randomized controlled trial. There were twenty patients in group A (with GnRH antagonist) and 40 patients in group B (without GnRH antagonist). In all of the participants, clomiphene citrate and human menopausal gonadotropin (CC+HMG) were used for ovarian stimulation. When at least one follicle with ≥ 16 mm diameter was seen, LH surge was checked by a urinary LH kit. In patients with negative results, human chorionic gonadotropin was continued in both groups, but in group A 0.25 mg Ganirelix SQ was administered for two days,,then in both groups human chorionic gonadotropin (HCG) was injected on the third day and IUI was done 36-40 hours later. Ongoing pregnancy was the primary outcome. Results: Baseline characters and clinical parameters were similar in both groups with the exception of ≥14 mm follicles which were higher in group A (p value = 0.003). The pregnancy rate in both groups was not significantly different, although it was higher in group B (10 % in group A and 15% in group B). Conclusion: At least in CC+HMG stimulated cycles for IUI, the occurrence of premature LH surge could have a useful rule and GnRH antagonist administration could be an inappropriate intervention