title: Role of gonadotropin-releasing hormone antagonist in the management of subfertile couples with intrauterine insemination and controlled ovarian stimulation.
abstract: OBJECTIVE
  To assess whether the clinical pregnancy rate of patients treated with recombinant FSH and IUI can be improved by the addition of a GnRH antagonist.
  
  
  METHODS
  Prospective, controlled study.
  
  
  METHODS
  Reproductive medicine clinic.
  
  
  METHODS
  Ninety-three patients with primary or secondary infertility.
  
  
  METHODS
  Patients were allocated to controlled ovarian stimulation with recombinant FSH (50-150 IU/d) only (control group, n=45) or to recombinant FSH (50-150 IU/d) plus ganirelix (0.25 mg/d, starting when the leading follicle was ≥16 mm; n=48). A single insemination was performed 36 hours after hCG was given (10,000 IU, IM) in both groups. Both groups were allowed at least three cycles.
  
  
  METHODS
  Clinical pregnancy rate, premature luteinization rate, and follicular development.
  
  
  RESULTS
  Clinical pregnancy rate (22% vs. 11%), cumulative pregnancy rate (52% vs. 31%), and number of mature follicles (2.1±1.08 vs. 1.4±0.95) were statistically significantly higher in the ganirelix group compared with the control group. The premature luteinization rate was significantly lower in the ganirelix group (1.7% vs. 17.5%).
  
  
  CONCLUSIONS
  The use of a GnRH antagonist in conjunction with controlled ovarian stimulation and IUI significantly increases pregnancy rates and reduces the incidence of premature luteinization.
authors.affiliation: Second Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens, Athens, Greece. p_bakas@yahoo.com
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Bakas
authors.forename: Sokratis
authors.initials: S
authors.lastname: Konidaris
authors.forename: Angelos
authors.initials: A
authors.lastname: Liapis
authors.forename: Odyseas
authors.initials: O
authors.lastname: Gregoriou
authors.forename: Despoina
authors.initials: D
authors.lastname: Tzanakaki
authors.forename: Georgios
authors.initials: G
authors.lastname: Creatsas
mesh_terms: D000328:Adult; D005191:Family Characteristics; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage / Q000627:therapeutic use; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000037:antagonists & inhibitors* / Q000627:therapeutic use; D006727:Hormone Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007246:Infertility / Q000188:drug therapy / Q000628:therapy*; D007315:Insemination, Artificial / Q000379:methods*; D008297:Male; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D014599:Uterus
chemical_list: D005300:Fertility Agents, Female; D006727:Hormone Antagonists; D011994:Recombinant Proteins; D007987:Gonadotropin-Releasing Hormone; D005640:Follicle Stimulating Hormone; C061018:ganirelix