Study of Positive and Negative Consequences of Using GnRH Antagonist in Intrauterine Insemination Cycles

Document Type : Original Article


1 Vali-e-Asr Reproductive Health Reaserch Center, Tehran University of Medical Science, Tehran, Iran

2 Fetal Maternal Health Research Center, Tehran University of Medical Science, Tehran, Iran


To assess the usefulness of premature luteinization hormone (LH) surge prevention in an intrauterine insemination (IUI) cycle by GnRH antagonist administration

Materials and methods
Sixty patients with unexplained or mild male infertility or minimal to mild endometriosis were enrolled in this prospective randomized controlled trial. There were twenty patients in group A (with GnRH antagonist) and 40 patients in group B (without GnRH antagonist). In all of the participants, clomiphene citrate and human menopausal gonadotropin (CC+HMG) were used for ovarian stimulation. When at least one follicle with ≥ 16 mm diameter was seen, LH surge was checked by a urinary LH kit. In patients with negative results, human chorionic gonadotropin was continued in both groups, but in group A 0.25 mg Ganirelix SQ was administered for two days, ,then in both groups human chorionic gonadotropin (HCG) was injected on the third day and IUI was done 36-40 hours later. Ongoing pregnancy was the primary outcome.

Baseline characters and clinical parameters were similar in both groups with the exception of ≥14 mm follicles which were higher in group A (p value= 0.003). The pregnancy rate in both groups was not significantly different, although it was higher in group B (10% in group A and 15% in group B).

At least in CC+HMG stimulated cycles for IUI, the occurrence of premature LH surge could have a useful rule and GnRH antagonist administration could be an inappropriate intervention.