腦下垂體拮抗劑可提高人工授精懷孕率

使用腦下垂體拮抗劑GnRHantagonist可能可提高人工授精IUI之懷孕率 (38 vs 14%)

http://humrep.oxfordjournals.org/content/20/2/368.full

Timing ovulation for intrauterine insemination with a GnRH antagonist

1. J.L. Gómez-Palomares1, 
2. B. Juliá2, 
3. B. Acevedo-Martín1,
4. M. Martínez-Burgos1, 
5. E.R. Hernández1,3 and 
6. E. Ricciarelli1

+Author Affiliations

1. ¹Clínica de Medicina de la Reproducción y Ginecología ‘FIVMadrid’, Madrid and ²Unidad de Reproducción, Hospital ‘Severo Ochoa’, Madrid, Spain

1. 3To whom correspondence should be addressed at: Clínica de Medicina de la Reproducción y Ginecología ‘FIV Madrid’, C/Álvarez de Baena 4 bajo, 28006 Madrid, Spain. Email: ehernandezm@fivmadrid.es

• Received June 7, 2004.
• Revision received August 6, 2004.
• Accepted October 15, 2004.

 

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Abstract

BACKGROUND: We aimed to assess the efficacy of a GnRH antagonist in intrauterine insemination (IUI) cycles to increase number of mature ovulatory follicles and pregnancy rates. METHODS: Prospective randomized study. Women (18–38 years old) with primary/secondary infertility were included. Eighty-two patients were randomly assigned to controlled ovarian stimulation (COS) consisting of rFSH + GnRH antagonist or rFSH alone. RESULTS: A non-significant increase in the total amount of rFSH was seen in the GnRH antagonist group (707±240 IU) with respect to the control group (657±194 IU). The number of mature follicles (≥16 mm) was significantly higher in the GnRH antagonist group than in the control group (2.4±1.4 versus 1.7±1.2, P<0.05). Pregnancy rates were significantly increased in the group of patients receiving the GnRH antagonist (38%) compared to the control group (14%). The only non-single pregnancy (triplets) occurred in the antagonist group. CONCLUSIONS: In this preliminary study, adding the GnRH antagonist to the COS protocol for IUI cycles significantly increased pregnancy rates. Nevertheless, these results may not be associated directly with the antagonist itself but with the fact that more mature ovulatory follicles are present by the day of the hCG. Finally, the risk for multiple gestations needs to be carefully evaluated.