Gonadotropin-releasing hormone antagonist use in controlled ovarian stimulation and intrauterine insemination cycles in women with polycystic ovary syndrome.
OBJECTIVE
To observe the effects of ganirelix on controlled ovarian stimulation and intrauterine insemination (COS/IUI) cycles in women with polycystic ovary syndrome (PCOS).


METHODS
Prospective, randomized, controlled clinical study.


METHODS
An academic clinical research center.


METHODS
Women with PCOS and anovulatory infertility undergoing COS/IUI.


METHODS
Recombinant FSH therapy was started on day 3. In women assigned to the control group (n = 47), treatment was continued up to the day of hCG administration. In patients assigned to receive GnRH antagonist (n = 42), ganirelix was added when the leading follicle was > or =14 mm.


METHODS
Pregnancy rates, serum E(2), P, and LH levels, and follicle numbers at hCG day, prevalence of premature luteinization, and cost of stimulation.


RESULTS
Serum E(2), P, and LH levels were significantly lower in the ganirelix group. Although premature luteinization and cycle cancellation was encountered less in the ganirelix group, the pregnancy rates per cycle were similar (15.4% vs. 10.7%). Patients would pay 6,153 dollars more for each pregnancy when using ganirelix.


CONCLUSIONS
Gonadotropin-releasing hormone antagonist resulted in more monofollicular development, less premature luteinization, and less cycle cancellation in IUI cycles of patients with PCOS; however, the cost of stimulation increased without an improvement in pregnancy rates.
Ertunc
Devrim
D
Department of Obstetrics and Gynecology, School of Medicine, Mersin University, Mersin, Turkey. devrimertunc@hotmail.com
Tok
Ekrem C
EC
Savas
Aysun
A
Ozturk
Ilay
I
Dilek
Saffet
S
D000328:Adult; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors* / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use; D006727:Hormone Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D007317:Insemination, Artificial, Homologous / Q000379:methods*; D008297:Male; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D011247:Pregnancy; D011446:Prospective Studies; D055815:Young Adult
D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone; C061018:ganirelix