The prevalence and influence of luteinizing hormone surges in stimulated cycles combined with intrauterine insemination during a prospective cohort study.
OBJECTIVE
To reveal the prevalence of premature LH surges in an IUI program. Furthermore, to investigate whether these LH surges influence treatment outcome and whether the prevalence of LH surges differs between cycles stimulated with clomiphene citrate (CC) and cycles stimulated with recombinant follicle-stimulating hormone (rFSH).


METHODS
Prospective cohort study.


METHODS
Subfertility patients in a tertiary institutional hospital.


METHODS
A total of 66 subfertile couples undergoing ovarian hyperstimulation combined with IUI.


METHODS
The women were randomized through a central blocked computer system, either to receive CC (33 couples) or rFSH (33 couples), both combined with IUI. Blood for LH determination was drawn on the day of human chorionic gonadotropin administration.


METHODS
LH surges as well as pregnancy rates.


RESULTS
In a total of 153 cycles, LH was measured. In 36% of these cycles, LH surges were detected. The results showed that in 42% of the rFSH-stimulated cycles an LH surge was detected, compared with 30% in the cycles with CC (odds ratio 1.7, 95% confidence interval 0.9 to 3.3). There was a nonsignificant trend showing higher pregnancy rates in cycles without an LH surge (odds ratio 2.7, 95% confidence interval 0.6 to 13).


CONCLUSIONS
Premature LH surges occur frequently, and they might influence treatment outcome negatively. Strategies to improve treatment outcome might focus on preventing premature LH surges.
Cantineau
Astrid E P
AE
Subfertility Unit, Department of Obstetrics and Gynaecology, Isala Clinics, Zwolle, The Netherlands. aepcantineau@og.umcg.nl
Cohlen
Bernard J
BJ
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007315:Insemination, Artificial / Q000379:methods*; D007986:Luteinizing Hormone / Q000097:blood*; D008597:Menstrual Cycle / Q000097:blood*; D010062:Ovulation Induction / Q000379:methods*; D010865:Pilot Projects; D011247:Pregnancy; D018873:Pregnancy Rate / Q000639:trends; D011446:Prospective Studies
D007986:Luteinizing Hormone