The Effects of Baseline Ovarian Cysts after GnRH-a Administrationon the Clinical Response to Controlled Ovarian Hyperstimulationfor Intrauterine Insemination

Kim, Yeun Pyo; Kim, Nak Yon; Kim, Chung Hoon; Kang, Byung Moon; Chang, Yoon Seok; Mok, Jung Eun

Abstract

The purpose of this study was to investigate the effects of baseline ovarian systs after luteal phase gonadotropin-releasing hormone agonist(GnRH-a) administration on the clinical response to controlled ovarian hyperstimulation(COH) for intrauterine insemination(IUI). From May 1994 to December 1995, 71 COH cycles using luteal long protocol of GnRH0a for IUI were assessed for the formation of baseline ovarian cysts defined as a mean diameter>or=15 mm. Outcome data were compared between cycles with and without baseline ovarian cysts. Of 71 COH cycles, baseline cyst>or=15 mm were noted in 23 cycles(32.4%). Of 23 cyst cycles, baseline cysts>or=20 mm were noted in 15 cycles and aspirated under transvaginal ultrasonogram guidance. There was no significant difference in baseline serum FSH values between cyst cycles and non-cyst cycles. There were also no significant differences in ovarian response as indicated by the number of ampules of gonadotropin used and duration of honadotropin administration in ovarian stimulation, and serum E2 level and number of follicles(>=14 mm) on the day of hCG administration between cyst cycles and non-cyst cycles. There was also no significant difference in endometrial thickness measured on the day of hCG administration between cyst cycles and non-cyst cycles. Clinical pregnancy rate was somewhat lower in cyst cycles compared with non-cyst cycles(13.0% versus 31.3%), but was not significantly different. This study suggests that baseline ovarian cysts after luteal phase GnRH-a administration has a potentially harmful effect on the clinical outcome in COH with IUI program.