Gonadotropin-releasing hormone antagonist use in controlled ovarian stimulation and intrauterine insemination cycles in women with polycystic ovary syndrome

• Published in: Fertility and sterility Vol. 93; no. 4; pp. 1179 - 1184
• Main Authors: Ertunc, Devrim, M.D, Tok, Ekrem C., M.D, Savas, Aysun, M.D, Ozturk, Ilay, M.D, Dilek, Saffet, M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-03-2010; Elsevier
• Subjects: Adult; Biological and medical sciences; Female; Female genital diseases; GnRH antagonist; Gonadotropin-Releasing Hormone - analogs & derivatives; Gonadotropin-Releasing Hormone - antagonists & inhibitors; Gonadotropin-Releasing Hormone - blood; Gonadotropin-Releasing Hormone - pharmacology; Gonadotropin-Releasing Hormone - therapeutic use; Gynecology. Andrology. Obstetrics; Hormone Antagonists - pharmacology; Hormone Antagonists - therapeutic use; Humans; Infertility, Female - blood; Infertility, Female - drug therapy; Infertility, Female - etiology; Insemination, Artificial, Homologous - methods; Internal Medicine; intrauterine insemination; Male; Medical sciences; Non tumoral diseases; Obstetrics and Gynecology; Ovulation Induction - methods; Polycystic ovary syndrome; Polycystic Ovary Syndrome - blood; Polycystic Ovary Syndrome - complications; Polycystic Ovary Syndrome - drug therapy; Pregnancy; Prospective Studies; Young Adult; Polycystic ovary syndrome; intrauterine insemination; GnRH antagonist; Human; Ovarian stimulation; Gynecology; Gonadotropin RH; Assisted procreation; Female sterility; Polycystic ovary; Obstetrics; Female genital diseases; Ovarian diseases; Uterus; Cyst; Artificial insemination; Female; Benign neoplasm; Antagonist; Woman
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/j.fertnstert.2008.11.030

Objective To observe the effects of ganirelix on controlled ovarian stimulation and intrauterine insemination (COS/IUI) cycles in women with polycystic ovary syndrome (PCOS). Design Prospective, randomized, controlled clinical study. Setting An academic clinical research center. Patient(s) Women with PCOS and anovulatory infertility undergoing COS/IUI. Intervention(s) 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 ≥14 mm. Main Outcome Measure(s) Pregnancy rates, serum E2 , P, and LH levels, and follicle numbers at hCG day, prevalence of premature luteinization, and cost of stimulation. Result(s) Serum E2 , 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 more for each pregnancy when using ganirelix. Conclusion(s) 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.