Open AccessAddition of gonadotrophin‐releasing hormone agonist and/or two inseminations with husband's sperm do not improve the pregnancy rate in superovulated cycles
Author(s) -
KARLSTRÖM PEROLOF,
BERGH TORBJÖRN,
LUNDKVIST ÖRJAN
Publication year - 2000
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1034/j.1600-0412.2000.079001037.x
Subject(s) - medicine , pregnancy , pregnancy rate , controlled ovarian hyperstimulation , unexplained infertility , menotropins , gynecology , infertility , gonadotropin releasing hormone , gestation , ovulation , hormone , andrology , endocrinology , ovulation induction , luteinizing hormone , biology , genetics
Background. A prospective randomized study was performed to evaluate the addition of a gonadotropin releasing hormone agonist (GnRH‐a) during treatment with human menopausal gonadotropins (hMG) in cycles with artificial inseminations with husband's washed sperm (AIH). We also compared the pregnancy rate per cycle after one versus two AIHs. Methods. We designed a 2 2 factorial trial. A total of 172 couples with unexplained infertility ( n =88), endometriosis ( n =39), or cervical ( n =24) or male ( n =21) factors were included, of whom 161 fulfilled the inclusion criteria and treatment. Eighty‐one women were treated with GnRH‐a/hMG and another 80 with hMG only, respectively. Results. The pregnancy rates did not differ between the two stimulation protocols (12% for GnRH‐a/hMG and 9% for hMG). With GnRH‐a/hMG more follicles >15 mm (3.4 and 2.4, respectively; p <0.01) and a higher multiple pregnancy rate after 20 weeks of gestation were observed (55% vs . 0%; p <0.05). Eighty‐seven women were treated with one AIH, whereas 65 women received two AIHs on two consecutive days. The pregnancy rates were similar in these two groups (11% and 9% respectively; n.s.) Conclusion. It is concluded that neither addition of GnRH‐a before and during controlled ovarian hyperstimulation nor two AIHs compared with one single AIH per cycle has a beneficial effect on the pregnancy rate. However, GnRH‐a increases the risk for multiple pregnancies.