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 preventionin an intrauterine insemination (IUI) cycle by GnRH antagonist administration.Materials and Methods: Sixty patients with unexplained or mild male infertility or minimalto mild endometriosis were enrolled in this prospective randomized controlled trial. There weretwenty patients in group A (with GnRH antagonist) and 40 patients in group B (without GnRHantagonist).In all of the participants, clomiphene citrate and human menopausal gonadotropin (CC+HMG) wereused for ovarian stimulation. When at least one follicle with ≥ 16 mm diameter was seen, LH surgewas checked by a urinary LH kit. In patients with negative results, human chorionic gonadotropinwas 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 IUIwas done 36-40 hours later. Ongoing pregnancy was the primary outcome.Results: Baseline characters and clinical parameters were similar in both groups with the exceptionof ≥14 mm follicles which were higher in group A (p value= 0.003). The pregnancy rate in bothgroups 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 LHsurge could have a useful rule and GnRH antagonist administration could be an inappropriateintervention.