The effectiveness of clomiphene citrate in LH surge suppression in women undergoing IUI: a randomized controlled trial.

OBJECTIVE

To study the effectiveness of clomiphene citrate (CC) in preventing a premature LH surge during controlled ovarian stimulation in women undergoing assisted reproduction.

DESIGN

Prospective, randomized, controlled trial.

SETTING

University hospital.

PATIENT(S): Two-hundred thirty couples with mild male factor, or unexplained infertility.

INTERVENTION(S): Couples were randomized to receive human menopausal gonadotrophins (hMG) followed by CC or hMG alone until the day of hCG.

MAIN OUTCOME MEASURE(S): The primary outcomes were the incidence of a clinical pregnancy and premature LH rise. Secondary outcomes were the E2 levels, number of mature follicles, and endometrial thickness as determined on the day of hCG.

RESULT(S): The number of patients who had a premature LH surge was significantly lower in the hMG+CC group (5.45% vs. 15.89%). Additionally, the mean E2 levels (pg/mL) and the number of mature follicles were also significantly higher in the hMG+CC group (360.3±162.9 vs. 280±110.0 and 2.4±0.97 vs. 1.3±1.1, respectively), although there was no significant difference regarding number of canceled cycles, endometrial thickness, or clinical pregnancy rate.

CONCLUSION(S): The addition of CC to hMG has been proven to be effective in reducing premature LH surges without compromising the pregnancy rate.