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- W1978390698 abstract "OBJECTIVE: To evaluate the outcome of GnRH antagonist treatment in gonadotropin-stimulated PCOS patients undergoing IUI. DESIGN: Prospective randomized controlled trial. MATERIALS AND METHODS: Anovulatory PCOS women undergoing ovulation induction cycles (n=143) with IUI (TMS > 5 million) were randomized into 3 Groups. Group 1: rec-FSH alone; Group 2: rec-FSH with GnRH-antagonist initiated when follicular size reached 13 mm in diameter; Group 3: rec-FSH with GnRH-antagonist given from day 1 of stimulation. The primary outcome measure was the clinical pregnancy rate (PR) per cycle initiated. Secondary outcome measures included the total gonadotropin dose per cycle, length of treatment, serum progesterone, LH and estradiol levels on day of hCG administration, premature luteinization rate and live birth rate per completed cycle. Power analysis showed 50 cycles per group were needed to demonstrate a 25% difference in PR at a significance level of ∝=.05 and β= 0.20. RESULTS: The clinical PR/cycle initiated and live birth rates per cycle completed in patients in Group 2, were higher(17/49,34%, 15/46,32%), compared with Groups 1 (11/50, 22%, 9/47,19%) or Group 3 (10/44,23%, 7/37,19%), P=0.09. All except 2 pregnancies were singletons (2 twins in Group 2). In the absence of antagonist (Group 1), premature luteinization occurred more often (20% vs. 0% vs. 2.% P<0.05).Table 1Group IGroup 2Group 3P# cycles504944Age30±431±430.5±4P=0.1r-FSH (IU)1251±7331313±9721325±606P=0.6peak estradiol(pg/mL)759±616699±788659±675P=0.7Peak LH IU/L10.4±8.63.1±2.53.2±6.7P=0.001follicles>162±1.52.4±1.82.2±1.9P=0.5t-test mean ± SD Open table in a new tab t-test mean ± SD CONCLUSIONS: Interim results show a clear trend for improved primary outcome in the flexible antagonist group. Premature luteinization occurred commonly in women with PCOS using rec-FSH alone and inhibition of LH may be the mechanism for the beneficial effect seen in Group 2." @default.
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- W1978390698 date "2009-09-01" @default.
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- W1978390698 title "Randomized controlled trial evaluating the effect of a GnRH-antagonist in women with PCOS undergoing ovulation induction with gonadotropins and intrauterine insemination (IUI): interim analysis" @default.
- W1978390698 doi "https://doi.org/10.1016/j.fertnstert.2009.07.311" @default.
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