A RANDOMIZED PROSPECTIVE-STUDY OF GONADOTROPIN WITH OR WITHOUT GONADOTROPIN-RELEASING-HORMONE AGONIST FOR TREATMENT OF UNEXPLAINED INFERTILITY

The use of gonadotrophin-releasing hormone agonist (GnRHa) in combinat ion with human menopausal gonadotrophin (HMG) for ovulation induction has been advocated for the treatment, particularly by in-vitro fertili zation (IVF) of various types of infertility. The present study was de signed to compare the clinical efficacy of HMG alone with a short prot ocol of GnRHa/HMG for treatment of unexplained infertility. A total of 91 couples with unexplained infertility were randomly assigned to one of two treatments; either HMG with intra-uterine insemination (IUI) ( 45 patients, 62 cycles) or GnRHa/HMG with IUI (46 patients, 69 cycles) treatments. Progesterone concentrations on the day of human chorionic gonadotrophin (HCG) administration were significantly higher in HMG ( 1.5 +/- 0.9 ng/ml) versus GnRHa/ HMG (0.8 +/- 0.6 ng/ml; P < 0.05) cyc les. Furthermore, GnRHa suppressed the occurrences of premature lutein ization (GnRHa/HMG 5.8% and HMG 24.2% respectively). However, there we re no significant differences in HMG dose requirements, plasma oestrad iol concentrations or follicular development on the day of HCG adminis tration between the two groups. Nor were any significant differences f ound in the pregnancy rates between the two treatment protocols (GnRHa /HMG 13.0% and HMG 11.3% respectively). Our results suggest no benefic ial effect of GnRHa/HMG compared to HMG alone for the treatment of une xplained infertility, based on pregnancy rates.