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JOURNAL ARTICLE

Effectiveness of spontaneous ovulation as monitored by urinary luteinizing hormone versus induced ovulation by administration of human chorionic gonadotropin in couples undergoing gonadotropin stimulated intrauterine insemination (IUI): a randomized controlled trial

Sumi Thomas, Tunny Sebastain, Muthukumar Karthikeyan, Ann M Mangalaraj, Aleyamma T Kunjummen, Mohan S Kamath
BJOG: An International Journal of Obstetrics and Gynaecology 2019 June 6
31169952

OBJECTIVE: To compare effectiveness of spontaneous ovulation monitored by urinary luteinizing hormone (LH) versus induced ovulation by administration of human chorionic gonadotropin (hCG) in couples undergoing gonadotropin stimulated IUI.

DESIGN: Randomized controlled trial.

SETTING: University level infertility unit.

POPULATION: Couples with unexplained infertility, mild endometriosis, mild male factor and polycystic ovarian syndrome (PCOS).

METHODS: Couples were randomized to LH group (Group A) where urinary LH was done daily to detect spontaneous ovulation or hCG group (Group B) where urinary hCG was administered as a trigger.

MAIN OUTCOME MEASURES: Clinical pregnancy rate. Secondary outcomes - ongoing pregnancy, live birth, multiple pregnancy and miscarriage rates.

RESULTS: A total of 392 couples were randomized with 196 in each arm. The clinical pregnancy rate per woman randomised was 14/196 (7.1%) in the LH arm vs. 15/196 (7.6%) in the hCG arm; P = 0.847 which was not statistically significant. Similarly, the ongoing pregnancy rates (13/196 (6.6%) vs. 14/196 (7.1%); P = 0.84) and the live birth rates (13/196 (6.6%) vs. 14/196 (7.1%); P = 0.84) between the two groups did not show any significant difference. The duration of stimulation and gonadotrophin dosage also did not differ significantly between the two methods.

CONCLUSION: There was no significant difference in clinical pregnancy rates when urinary LH and hCG trigger as methods to time insemination were compared in women undergoing gonadotropin stimulated IUI. This article is protected by copyright. All rights reserved.

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