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GnRH agonist administration at the time of implantation does not improve pregnancy outcome in intrauterine insemination cycles: a randomized controlled trial

GnRH agonist administration at the time of implantation does not improve pregnancy outcome in intrauterine insemination cycles: a randomized controlled trial

Authors: Jose Bellver, Elena Labarta, Ernesto Bosch, Marco Melo, Carmina Vidal, Jose Remoh, and Antonio Pellicer

(Fertility & Sterility 94: 1065- 1071, 2010)

Objective: To assess whether GnRH agonist administration in the luteal phase improves pregnancy outcome in intrauterine insemination (IUI) cycles.

Design: Single-center, randomized, single-blind, placebo-controlled trial.

Setting: University-affiliated infertility clinic, between February 2005 and December 2007.

Patient(s): Three hundred forty-four women undergoing IUI owing to mild to moderate male factor or donor sperm indication.

Intervention(s): Random administration to either a single subcutaneous injection of 0.1 mg triptorelin (group A; n= 172) 8 days after hCG administration, or solvent only (group B; n= 172) at the same time.

Main Outcome Measure(s): Pregnancy rate was the primary outcome measure considered for assessing the role of triptorelin administration at the time of implantation. Clinical pregnancy, miscarriage, and ongoing pregnancy rates were the secondary outcome measures.

Result(s): No differences were detected between the groups regarding clinical, seminal, or ovarian stimulation parameters. Pregnancy rate per randomized patient was similar in both groups (22.7% vs. 22.1%), as were clinical pregnancy, miscarriage, and ongoing pregnancy rates. There was a significant increase in the proportion of multiple pregnancies in the placebo group (10.3%
vs. 36.8%).

Conclusion(s): Administration of GnRH agonist at the time of implantation does not improve the reproductive outcome of IUI cycles.

KeyWords: GnRH agonists, intrauterine insemination, pregnancy, outcome, luteal phase