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Comparative Study
. 1997 Oct;14(9):518-24.
doi: 10.1023/a:1021127410300.

Endogenous LH surge versus hCG as ovulation trigger after low-dose highly purified FSH in IUI: a comparison of 761 cycles

A Romeu  1 , A Monzó, T Peiró, E Diez, J A Peinado, L A Quintero
Affiliations
Comparative Study

Endogenous LH surge versus hCG as ovulation trigger after low-dose highly purified FSH in IUI: a comparison of 761 cycles

A Romeu et al. J Assist Reprod Genet. 1997 Oct.

Abstract

Purpose: The results obtained with a protocol consisting of ovarian stimulation with low doses of highly purified FSH (FSH HP), administration of a GnRH analogue to induce an endogenous surge of gonadotropins, and IUI were evaluated. These results were compared with those seen with similar FSH stimulation and hCG administration followed by IUI.

Methods: Three hundred sixty-four patients scheduled for IUI, after inclusion in a total of 345 FSH HP/GnRH-stimulated cycles and 416 FSH HP/HCG-stimulated cycles, were studied. The stimulation protocol consisted of daily subcutaneous injection of 75 IU of FSH HP from day 3 or 5 of the cycle, depending on the duration of the spontaneous cycle. hCG was administered on days 0, +2, and +5 to support the luteal phase. Monitoring was conducted using circulating estradiol levels and vaginal ultrasonography. Administration of two s.c. doses of leuprolide acetate (LA) or 7500 IU of i.m. hCG when at least one 18-mm-diameter follicle was seen and estradiol levels reached 120 pg/ml per follicle with a diameter > or = 16 mm. Intrauterine insemination was with semen capacitated by swim-up, thawed at room temperature if previously frozen.

Results: The ovulation rate was 99.28 after hCG and 99.23 with LA. No significant differences were seen between the estradiol and progesterone levels of both groups or in the estradiol/progesterone ratio. The duration of the luteal phase was similar in both groups. Pregnancy rates per cycle were 17.31% (hCG) and 27.25% (LA), respectively (P = 0.0007), and abortion rates 22.22% (hCG) and 24.47% (LA), respectively. No cases of ovarian hyperstimulation were seen.

Conclusions: After FSH HP administration according to a low-dose protocol, the use of LA to trigger a gonadotropin surge as a means of inducing ovulation in FSH-stimulated women could be a good alternative to improve the results and prevent ovarian hyperstimulation in IUI cycles.

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References

    1. Schenker J, Weinstein D. Ovarian hyperstimulation syndrome: A current survey. Fertil Steril. 1978;30:255–268. - PubMed
    1. Navot D, Rebou A, Birkenfeld A. Risk factors and prognostic variables in the ovarian hyperstimulation syndrome. Am J Obstet Gynecol. 1988;159:210–216. - PubMed
    1. Homburg R, Levy T, Ben-Rafael Z. A comparative prospective study of conventional regimen with chronic low-dose administration of follicle-stimulating hormone for anovulation associated with policystic ovary syndrome. Fertil Steril. 1995;63:729–733. - PubMed
    1. Balasch J, Ballesca JL, Pimentel C, Creus M, Fabregues F, Vanrell JA. Late low-dose pure follicle stimulating hormone for ovarian stimulation in intra-uterine insemination cycles. Hum Reprod. 1994;9:1863–1866. - PubMed
    1. Balasch J, Tur R, Peinado JA. The safety and effectiveness of stepwise and low-dose administration of follicle stimulating hormone in WHO group II anovulatory infertile women: Evidence from a large multicenter study in Spain. J Assist Reprod Genet. 1996;13:551–556. - PubMed

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