GnRH agonist - Increasing the pregnancy rate after combined treatment withhMG/hCG and direct intraperitoneal insemination

OBJECTIVE: To evaluate the efficacy of the GnRH agonist (GnRHa) administere d in conjunction with human menopausal gonadotropin/human chorionic gonadot ropin hMG/hCG and direct intraperitoneal insemination (DIPI) in women with longstanding unexplained infertility. STUDY DESIGN: A prospective, randomized, nonblind analysis. During the peri od May 1995 - December 1996, couples with unexplained infertility who faile d to conceive following superovulation combined with IUI for at least seven cycles were prospectively enrolled and followed. Pregnancy rates per cycle and per patient of DIPI were compared between groups of hMG/hCG with (GnRH a[+] controlled ovarian hyperstimulation [COH] group) or without (GnRHa [-] COH group) GnRHa. RESULTS: Thirty-four womelz (59 cycles) underwent COH with hMG and GnRHa, a nd 31 women (49 cycles) received hyperstimulation with hMG alone. The pregn ancy rates for the women administered GnRHa significantly exceeded those of the patients who did not receive GnRHa both per treatment cycle (35.6% ver sus 14.3%) and per couple (55.9% versus 22.5%). CONCLUSION: The use of GnRHa with hMG/hCG and DIPI treatment significantly increased the pregnancy rate in women with longstanding infertility.