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

ObjectiveTo study the effectiveness of clomiphene citrate (CC) in preventing a premature LH surge during controlled ovarian stimulation in women undergoing assisted reproduction.DesignProspective, randomized, controlled trial.SettingUniversity 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.