Fertility and Sterility
Volume 94, Issue 6 , Pages 2167-2171, November 2010

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

  • Hesham Al-Inany, M.D., Ph.D.

      Affiliations

    • Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt
    • Corresponding Author InformationReprint requests: Hesham Al-Inany, M.D., Ph.D. 8-Moustapha Hassanin St, Manial, Cairo 11451, Egypt.
    • ,
  • Hamdy Azab, M.D.

      Affiliations

    • Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt
    • ,
  • Waleed El-Khayat, M.D.

      Affiliations

    • Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt
    • ,
  • Adel Nada, M.D.

      Affiliations

    • Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt
    • ,
  • Eman El-Khattan, M.D.

      Affiliations

    • Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt
    • ,
  • Ahmed M. Abou-Setta, M.D., Ph.D.

      Affiliations

    • Alberta Research Centre for Health Evidence, University of Alberta, Edmonton, Alberta, Canada

Received 19 September 2009; received in revised form 24 January 2010; accepted 26 January 2010. published online 16 March 2010.

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.

Key words: COS, IUI, CC, premature LH surge

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 H.A.-I. has nothing to disclose. H.A. has nothing to disclose. W.E.-K. has nothing to disclose. A.N. has nothing to disclose. E.E.-K. has nothing to disclose. A.A.-S. has nothing to disclose.

PII: S0015-0282(10)00144-5

doi:10.1016/j.fertnstert.2010.01.069

Fertility and Sterility
Volume 94, Issue 6 , Pages 2167-2171, November 2010

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