Role of gonadotropin-releasing hormone antagonist in the management of subfertile couples with intrauterine insemination and controlled ovarian stimulation
Objective To assess whether the clinical pregnancy rate of patients treated with recombinant FSH and IUI can be improved by the addition of a GnRH antagonist. Design Prospective, controlled study. Setting Reproductive medicine clinic. Patient(s) Ninety-three patients with primary or secondary infert...
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| Veröffentlicht in: | Fertility and sterility 2011-05, Vol.95 (6), p.2024-2028 |
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| creator | Bakas, Panagiotis, M.D Konidaris, Sokratis, M.D Liapis, Angelos, M.D Gregoriou, Odyseas, M.D Tzanakaki, Despoina, M.D Creatsas, Georgios, M.D |
| description | Objective To assess whether the clinical pregnancy rate of patients treated with recombinant FSH and IUI can be improved by the addition of a GnRH antagonist. Design Prospective, controlled study. Setting Reproductive medicine clinic. Patient(s) Ninety-three patients with primary or secondary infertility. Intervention(s) Patients were allocated to controlled ovarian stimulation with recombinant FSH (50–150 IU/d) only (control group, n = 45) or to recombinant FSH (50–150 IU/d) plus ganirelix (0.25 mg/d, starting when the leading follicle was ≥16 mm; n = 48). A single insemination was performed 36 hours after hCG was given (10,000 IU, IM) in both groups. Both groups were allowed at least three cycles. Main Outcome Measure(s) Clinical pregnancy rate, premature luteinization rate, and follicular development. Result(s) Clinical pregnancy rate (22% vs. 11%), cumulative pregnancy rate (52% vs. 31%), and number of mature follicles (2.1 ± 1.08 vs. 1.4 ± 0.95) were statistically significantly higher in the ganirelix group compared with the control group. The premature luteinization rate was significantly lower in the ganirelix group (1.7% vs. 17.5%). Conclusion(s) The use of a GnRH antagonist in conjunction with controlled ovarian stimulation and IUI significantly increases pregnancy rates and reduces the incidence of premature luteinization. |
| doi_str_mv | 10.1016/j.fertnstert.2011.01.167 |
| format | Article |
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Design Prospective, controlled study. Setting Reproductive medicine clinic. Patient(s) Ninety-three patients with primary or secondary infertility. Intervention(s) Patients were allocated to controlled ovarian stimulation with recombinant FSH (50–150 IU/d) only (control group, n = 45) or to recombinant FSH (50–150 IU/d) plus ganirelix (0.25 mg/d, starting when the leading follicle was ≥16 mm; n = 48). A single insemination was performed 36 hours after hCG was given (10,000 IU, IM) in both groups. Both groups were allowed at least three cycles. Main Outcome Measure(s) Clinical pregnancy rate, premature luteinization rate, and follicular development. Result(s) Clinical pregnancy rate (22% vs. 11%), cumulative pregnancy rate (52% vs. 31%), and number of mature follicles (2.1 ± 1.08 vs. 1.4 ± 0.95) were statistically significantly higher in the ganirelix group compared with the control group. The premature luteinization rate was significantly lower in the ganirelix group (1.7% vs. 17.5%). Conclusion(s) The use of a GnRH antagonist in conjunction with controlled ovarian stimulation and IUI significantly increases pregnancy rates and reduces the incidence of premature luteinization.</description><identifier>ISSN: 0015-0282</identifier><identifier>EISSN: 1556-5653</identifier><identifier>DOI: 10.1016/j.fertnstert.2011.01.167</identifier><identifier>PMID: 21334613</identifier><identifier>CODEN: FESTAS</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject><![CDATA[Adult ; animal ovaries ; antagonists ; Biological and medical sciences ; Birth control ; controlled ovarian stimulation ; Family Characteristics ; Female ; Fertility Agents, Female - administration & dosage ; Fertility Agents, Female - therapeutic use ; Follicle Stimulating Hormone - administration & dosage ; Follicle Stimulating Hormone - therapeutic use ; follicle-stimulating hormone ; follicular development ; ganirelix ; GnRH antagonist ; gonadotropin-releasing hormone ; Gonadotropin-Releasing Hormone - administration & dosage ; Gonadotropin-Releasing Hormone - analogs & derivatives ; Gonadotropin-Releasing Hormone - antagonists & inhibitors ; Gonadotropin-Releasing Hormone - therapeutic use ; Gynecology. Andrology. Obstetrics ; hormone antagonists ; Hormone Antagonists - administration & dosage ; Hormone Antagonists - therapeutic use ; human chorionic gonadotropin ; Humans ; Infertility - drug therapy ; Infertility - therapy ; insemination ; Insemination, Artificial - methods ; Internal Medicine ; IUI ; luteinization ; Male ; Medical sciences ; medicine ; Obstetrics and Gynecology ; ovarian stimulation ; Ovulation Induction - methods ; patients ; Pregnancy ; Pregnancy Rate ; pregnancy rates ; Recombinant Proteins - administration & dosage ; Recombinant Proteins - therapeutic use ; Sterility. Assisted procreation ; Uterus]]></subject><ispartof>Fertility and sterility, 2011-05, Vol.95 (6), p.2024-2028</ispartof><rights>American Society for Reproductive Medicine</rights><rights>2011 American Society for Reproductive Medicine</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c532t-69145f2fbc31a825caf7af43e2f67b1b11cc3acedffc4e72e86a30118dd33c383</citedby><cites>FETCH-LOGICAL-c532t-69145f2fbc31a825caf7af43e2f67b1b11cc3acedffc4e72e86a30118dd33c383</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.fertnstert.2011.01.167$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3549,27923,27924,45994</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24163208$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21334613$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bakas, Panagiotis, M.D</creatorcontrib><creatorcontrib>Konidaris, Sokratis, M.D</creatorcontrib><creatorcontrib>Liapis, Angelos, M.D</creatorcontrib><creatorcontrib>Gregoriou, Odyseas, M.D</creatorcontrib><creatorcontrib>Tzanakaki, Despoina, M.D</creatorcontrib><creatorcontrib>Creatsas, Georgios, M.D</creatorcontrib><title>Role of gonadotropin-releasing hormone antagonist in the management of subfertile couples with intrauterine insemination and controlled ovarian stimulation</title><title>Fertility and sterility</title><addtitle>Fertil Steril</addtitle><description>Objective To assess whether the clinical pregnancy rate of patients treated with recombinant FSH and IUI can be improved by the addition of a GnRH antagonist. Design Prospective, controlled study. Setting Reproductive medicine clinic. Patient(s) Ninety-three patients with primary or secondary infertility. Intervention(s) Patients were allocated to controlled ovarian stimulation with recombinant FSH (50–150 IU/d) only (control group, n = 45) or to recombinant FSH (50–150 IU/d) plus ganirelix (0.25 mg/d, starting when the leading follicle was ≥16 mm; n = 48). A single insemination was performed 36 hours after hCG was given (10,000 IU, IM) in both groups. Both groups were allowed at least three cycles. Main Outcome Measure(s) Clinical pregnancy rate, premature luteinization rate, and follicular development. Result(s) Clinical pregnancy rate (22% vs. 11%), cumulative pregnancy rate (52% vs. 31%), and number of mature follicles (2.1 ± 1.08 vs. 1.4 ± 0.95) were statistically significantly higher in the ganirelix group compared with the control group. The premature luteinization rate was significantly lower in the ganirelix group (1.7% vs. 17.5%). Conclusion(s) The use of a GnRH antagonist in conjunction with controlled ovarian stimulation and IUI significantly increases pregnancy rates and reduces the incidence of premature luteinization.</description><subject>Adult</subject><subject>animal ovaries</subject><subject>antagonists</subject><subject>Biological and medical sciences</subject><subject>Birth control</subject><subject>controlled ovarian stimulation</subject><subject>Family Characteristics</subject><subject>Female</subject><subject>Fertility Agents, Female - administration & dosage</subject><subject>Fertility Agents, Female - therapeutic use</subject><subject>Follicle Stimulating Hormone - administration & dosage</subject><subject>Follicle Stimulating Hormone - therapeutic use</subject><subject>follicle-stimulating hormone</subject><subject>follicular development</subject><subject>ganirelix</subject><subject>GnRH antagonist</subject><subject>gonadotropin-releasing hormone</subject><subject>Gonadotropin-Releasing Hormone - administration & dosage</subject><subject>Gonadotropin-Releasing Hormone - analogs & derivatives</subject><subject>Gonadotropin-Releasing Hormone - antagonists & inhibitors</subject><subject>Gonadotropin-Releasing Hormone - therapeutic use</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>hormone antagonists</subject><subject>Hormone Antagonists - administration & dosage</subject><subject>Hormone Antagonists - therapeutic use</subject><subject>human chorionic gonadotropin</subject><subject>Humans</subject><subject>Infertility - drug therapy</subject><subject>Infertility - therapy</subject><subject>insemination</subject><subject>Insemination, Artificial - methods</subject><subject>Internal Medicine</subject><subject>IUI</subject><subject>luteinization</subject><subject>Male</subject><subject>Medical sciences</subject><subject>medicine</subject><subject>Obstetrics and Gynecology</subject><subject>ovarian stimulation</subject><subject>Ovulation Induction - methods</subject><subject>patients</subject><subject>Pregnancy</subject><subject>Pregnancy Rate</subject><subject>pregnancy rates</subject><subject>Recombinant Proteins - administration & dosage</subject><subject>Recombinant Proteins - therapeutic use</subject><subject>Sterility. Assisted procreation</subject><subject>Uterus</subject><issn>0015-0282</issn><issn>1556-5653</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNks9u1DAQxiMEoqXwCuAL4pTFYydOekGiFf-kSkiUnq1ZZ7zrJbEX2ynqs_CyOOxCJU5cPAf_5ptP801VMeAr4KBe71aWYvYpl3clOMCKwwpU96A6hbZVdata-bA65RzamotenFRPUtpxzhV04nF1IkDKRoE8rX5-CSOxYNkmeBxCjmHvfB1pJEzOb9g2xCl4YugzFsSlzJxneUtsQo8bmsjnpT3N68WSK2ImzPuREvvh8rbAOeJcfLoi4nyiyXnMLviiOBS0fIdxpIGFW4wOPUvZTfP4G3laPbI4Jnp2rGfVzft3Xy8_1lefP3y6fHtVm1aKXKtzaFor7NpIwF60Bm2HtpEkrOrWsAYwRqKhwVrTUCeoVyjLzvphkNLIXp5Vrw66-xi-z5SynlwyNI7oKcxJ90o2om16Ucj-QJoYUopk9T66CeOdBq6XZPRO3yejl2Q0B12SKa3Pj0Pm9UTD38Y_URTg5RHAZHC0Eb1x6Z5rQEnBF7cvDpzFoHETC3NzXSa1JW3RqW4ZdXEgqCzt1lHUyTjyZQMuksl6CO5__L75R8SMzrvi7BvdUdqFOfoSigadhOb6erm15dQAOBeNOpe_AB441ck</recordid><startdate>20110501</startdate><enddate>20110501</enddate><creator>Bakas, Panagiotis, M.D</creator><creator>Konidaris, Sokratis, M.D</creator><creator>Liapis, Angelos, M.D</creator><creator>Gregoriou, Odyseas, M.D</creator><creator>Tzanakaki, Despoina, M.D</creator><creator>Creatsas, Georgios, M.D</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>FBQ</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110501</creationdate><title>Role of gonadotropin-releasing hormone antagonist in the management of subfertile couples with intrauterine insemination and controlled ovarian stimulation</title><author>Bakas, Panagiotis, M.D ; Konidaris, Sokratis, M.D ; Liapis, Angelos, M.D ; Gregoriou, Odyseas, M.D ; Tzanakaki, Despoina, M.D ; Creatsas, Georgios, M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c532t-69145f2fbc31a825caf7af43e2f67b1b11cc3acedffc4e72e86a30118dd33c383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>animal ovaries</topic><topic>antagonists</topic><topic>Biological and medical sciences</topic><topic>Birth control</topic><topic>controlled ovarian stimulation</topic><topic>Family Characteristics</topic><topic>Female</topic><topic>Fertility Agents, Female - administration & dosage</topic><topic>Fertility Agents, Female - therapeutic use</topic><topic>Follicle Stimulating Hormone - administration & dosage</topic><topic>Follicle Stimulating Hormone - therapeutic use</topic><topic>follicle-stimulating hormone</topic><topic>follicular development</topic><topic>ganirelix</topic><topic>GnRH antagonist</topic><topic>gonadotropin-releasing hormone</topic><topic>Gonadotropin-Releasing Hormone - administration & dosage</topic><topic>Gonadotropin-Releasing Hormone - analogs & derivatives</topic><topic>Gonadotropin-Releasing Hormone - antagonists & inhibitors</topic><topic>Gonadotropin-Releasing Hormone - therapeutic use</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>hormone antagonists</topic><topic>Hormone Antagonists - administration & dosage</topic><topic>Hormone Antagonists - therapeutic use</topic><topic>human chorionic gonadotropin</topic><topic>Humans</topic><topic>Infertility - drug therapy</topic><topic>Infertility - therapy</topic><topic>insemination</topic><topic>Insemination, Artificial - methods</topic><topic>Internal Medicine</topic><topic>IUI</topic><topic>luteinization</topic><topic>Male</topic><topic>Medical sciences</topic><topic>medicine</topic><topic>Obstetrics and Gynecology</topic><topic>ovarian stimulation</topic><topic>Ovulation Induction - methods</topic><topic>patients</topic><topic>Pregnancy</topic><topic>Pregnancy Rate</topic><topic>pregnancy rates</topic><topic>Recombinant Proteins - administration & dosage</topic><topic>Recombinant Proteins - therapeutic use</topic><topic>Sterility. Assisted procreation</topic><topic>Uterus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bakas, Panagiotis, M.D</creatorcontrib><creatorcontrib>Konidaris, Sokratis, M.D</creatorcontrib><creatorcontrib>Liapis, Angelos, M.D</creatorcontrib><creatorcontrib>Gregoriou, Odyseas, M.D</creatorcontrib><creatorcontrib>Tzanakaki, Despoina, M.D</creatorcontrib><creatorcontrib>Creatsas, Georgios, M.D</creatorcontrib><collection>AGRIS</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Fertility and sterility</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bakas, Panagiotis, M.D</au><au>Konidaris, Sokratis, M.D</au><au>Liapis, Angelos, M.D</au><au>Gregoriou, Odyseas, M.D</au><au>Tzanakaki, Despoina, M.D</au><au>Creatsas, Georgios, M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Role of gonadotropin-releasing hormone antagonist in the management of subfertile couples with intrauterine insemination and controlled ovarian stimulation</atitle><jtitle>Fertility and sterility</jtitle><addtitle>Fertil Steril</addtitle><date>2011-05-01</date><risdate>2011</risdate><volume>95</volume><issue>6</issue><spage>2024</spage><epage>2028</epage><pages>2024-2028</pages><issn>0015-0282</issn><eissn>1556-5653</eissn><coden>FESTAS</coden><abstract>Objective To assess whether the clinical pregnancy rate of patients treated with recombinant FSH and IUI can be improved by the addition of a GnRH antagonist. Design Prospective, controlled study. Setting Reproductive medicine clinic. Patient(s) Ninety-three patients with primary or secondary infertility. Intervention(s) Patients were allocated to controlled ovarian stimulation with recombinant FSH (50–150 IU/d) only (control group, n = 45) or to recombinant FSH (50–150 IU/d) plus ganirelix (0.25 mg/d, starting when the leading follicle was ≥16 mm; n = 48). A single insemination was performed 36 hours after hCG was given (10,000 IU, IM) in both groups. Both groups were allowed at least three cycles. Main Outcome Measure(s) Clinical pregnancy rate, premature luteinization rate, and follicular development. Result(s) Clinical pregnancy rate (22% vs. 11%), cumulative pregnancy rate (52% vs. 31%), and number of mature follicles (2.1 ± 1.08 vs. 1.4 ± 0.95) were statistically significantly higher in the ganirelix group compared with the control group. The premature luteinization rate was significantly lower in the ganirelix group (1.7% vs. 17.5%). Conclusion(s) The use of a GnRH antagonist in conjunction with controlled ovarian stimulation and IUI significantly increases pregnancy rates and reduces the incidence of premature luteinization.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21334613</pmid><doi>10.1016/j.fertnstert.2011.01.167</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Fertility and sterility, 2011-05, Vol.95 (6), p.2024-2028 |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adult animal ovaries antagonists Biological and medical sciences Birth control controlled ovarian stimulation Family Characteristics Female Fertility Agents, Female - administration & dosage Fertility Agents, Female - therapeutic use Follicle Stimulating Hormone - administration & dosage Follicle Stimulating Hormone - therapeutic use follicle-stimulating hormone follicular development ganirelix GnRH antagonist gonadotropin-releasing hormone Gonadotropin-Releasing Hormone - administration & dosage Gonadotropin-Releasing Hormone - analogs & derivatives Gonadotropin-Releasing Hormone - antagonists & inhibitors Gonadotropin-Releasing Hormone - therapeutic use Gynecology. Andrology. Obstetrics hormone antagonists Hormone Antagonists - administration & dosage Hormone Antagonists - therapeutic use human chorionic gonadotropin Humans Infertility - drug therapy Infertility - therapy insemination Insemination, Artificial - methods Internal Medicine IUI luteinization Male Medical sciences medicine Obstetrics and Gynecology ovarian stimulation Ovulation Induction - methods patients Pregnancy Pregnancy Rate pregnancy rates Recombinant Proteins - administration & dosage Recombinant Proteins - therapeutic use Sterility. Assisted procreation Uterus |
| title | Role of gonadotropin-releasing hormone antagonist in the management of subfertile couples with intrauterine insemination and controlled ovarian stimulation |
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