Gonadotropin-releasing hormone agonist improves the efficiency of controlled ovarian hyperstimulation/intrauterine insemination.
OBJECTIVE
Leuprolide acetate (LA) has improved the efficiency of human menopausal gonadotropins (hMG) in in vitro fertilization cycles. We hypothesized that the combination of LA/hMG/intrauterine insemination (IUI) would be more efficacious than hMG/IUI cycles.


METHODS
During an 18-month period, all patients completing either a hMG/IUI cycle (group I) or a LA/hMG/IUI cycle (group II) had the characteristics and outcomes of their stimulation cycles assessed. The groups were not prospectively randomized.


METHODS
Referral center at a tertiary care hospital.


METHODS
One hundred twenty three patients in group I completed 219 cycles, and 64 patients in group II completed 102 cycles. Twenty-eight of the patients who failed to conceive with hMG/IUI were advanced to group II.


METHODS
Pregnancy/IUI is compared between the two groups.


RESULTS
Group II demonstrated significantly greater clinical pregnancy/IUI than group I (26.5% and 16.0%, respectively, P less than 0.05), as well as a higher live birth/IUI (21.6% and 12.8%, respectively, P less than 0.05). No difference was present in the rate of fetal wastage or multiple births.


CONCLUSIONS
In our patients with recalcitrant infertility, the addition of a gonadotropin-releasing hormone agonist to hMG/IUI improved the pregnancy rate, without increasing the rate of multiple births or fetal wastage.
Gagliardi
C L
CL
Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark 07103.
Emmi
A M
AM
Weiss
G
G
Schmidt
C L
CL
D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007246:Infertility / Q000209:etiology / Q000628:therapy; D007315:Insemination, Artificial / Q000379:methods*; D016729:Leuprolide; D008297:Male; D008596:Menotropins / Q000008:administration & dosage / Q000627:therapeutic use*; D010053:Ovary / Q000502:physiology*; D011247:Pregnancy; D011272:Pregnancy, Multiple
D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins; D016729:Leuprolide