study of positive and negative consequences of using gnrh antagonist in intrauterine insemination cycles

background: to assess the usefulness of premature luteinization hormone (lh) surge prevention in an intrauterine insemination (iui) cycle by gnrh antagonist administration materials and methods: sixty patients with unexplained or mild male infertility or minimal to mild endometriosis were enrolled in this prospective randomized controlled trial. there were twenty patients in group a (with gnrh antagonist) and 40 patients in group b (without gnrh antagonist). in all of the participants, clomiphene citrate and human menopausal gonadotropin (cc+hmg) were used for ovarian stimulation. when at least one follicle with ≥ 16 mm diameter was seen, lh surge was checked by a urinary lh kit. in patients with negative results, human chorionic gonadotropin was continued in both groups, but in group a 0.25 mg ganirelix sq was administered for two days, ,then in both groups human chorionic gonadotropin (hcg) was injected on the third day and iui was done 36-40 hours later. ongoing pregnancy was the primary outcome. results: baseline characters and clinical parameters were similar in both groups with the exception of ≥14 mm follicles which were higher in group a (p value= 0.003). the pregnancy rate in both groups was not significantly different, although it was higher in group b (10% in group a and 15% in group b). conclusion: at least in cc+hmg stimulated cycles for iui, the occurrence of premature lh surge could have a useful rule and gnrh antagonist administration could be an inappropriate intervention.