Le Minh Tam, Nguyen Dac Nguyen, Zolton Jessica, Nguyen Vu Quoc Huy, Truong Quang Vinh, Cao Ngoc Thanh, Decherney Alan, Hill Micah J
Department of OBGYN, Hue University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen Street, Hue, Vietnam.
Department of OBGYN, Walter Reed National Military Medical Center, Bethesda, MD, USA.
Int J Endocrinol. 2019 Mar 13;2019:2487067. doi: 10.1155/2019/2487067. eCollection 2019.
This study is aimed at comparing clinical pregnancy rates (CPRs) in patients who are administered either gonadotropin-releasing hormone agonist (GnRHa) or human chorionic gonadotropin (hCG) for ovulation trigger in intrauterine insemination (IUI) cycles. A prospective randomized comparative study was conducted at Hue University Hospital in Vietnam. A total of 197 infertile women were randomly assigned to receive either GnRHa trigger ( = 98 cycles) or hCG trigger ( = 99 cycles) for ovulation trigger. Patients returned for ultrasound monitoring 24 hours after IUI to confirm ovulation. A clinical pregnancy was defined as the presence of gestational sac with fetal cardiac activity. There was no difference in ovulation rates in either group receiving GnRHa or hCG trigger for ovulation. Biochemical and CPR were higher in patients who received hCG (28.3% and 23.2%) versus GnRHa (14.3% and 13.3%) ( = 0.023, OR 0.42, 95%CI = 0.21 - 0.86 and = 0.096, OR 0.51, 95%CI = 0.24 - 1.07, respectively). After adjusting for body mass index (BMI) and infertility duration, there was no difference in CPR between the two groups (OR 0.58, 95% CI 0.27-1.25, = 0.163). In conclusion, the use of the GnRHa to trigger ovulation in patients undergoing ovulation induction may be considered in patients treated with IUI.
本研究旨在比较在宫内人工授精（IUI）周期中，接受促性腺激素释放激素激动剂（GnRHa）或人绒毛膜促性腺激素（hCG）进行排卵触发的患者的临床妊娠率（CPR）。在越南顺化大学医院进行了一项前瞻性随机对照研究。共有197名不孕女性被随机分配接受GnRHa触发（98个周期）或hCG触发（99个周期）进行排卵触发。患者在IUI后24小时返回进行超声监测以确认排卵。临床妊娠定义为存在带有胎心活动的妊娠囊。接受GnRHa或hCG触发排卵的两组患者的排卵率没有差异。接受hCG的患者（28.3%和23.2%）的生化妊娠率和临床妊娠率高于接受GnRHa的患者（14.3%和13.3%）（P = 0.023，OR 0.42，95%CI = 0.21 - 0.86；P = 0.096，OR 0.51，95%CI = 0.24 - 1.07）。在调整体重指数（BMI）和不孕持续时间后，两组之间的临床妊娠率没有差异（OR 0.58，95%CI 0.27 - 1.25，P = 0.163）。总之，在接受IUI治疗的患者中，对于接受排卵诱导的患者，可考虑使用GnRHa触发排卵。
