A randomized, multicenter study comparing the efficacy of recombinant FSH vs recombinant FSH with Ganirelix during superovulation/IUI therapy.

OBJECTIVE: The purpose of this study was to determine if use of a Gonadotropin releasing hormone (GnRH) antagonist, Ganirelix (Antagon), can improve pregnancy rates during superovulation with recombinant follicle-stimulating hormone (rFSH) followed by intrauterine insemination (IUI). STUDY DESIGN: This was a multicenter, prospective, randomized, open-label, assessor-blind, controlled trial of females (n = 54), ages 18 to 39 undergoing superovulation/IUI with up to 4 cycles of superovulation/IUI without Ganirelix (n = 66), or up to 4 cycles of superovulation/IUI with the addition of Ganirelix (n = 52). RESULTS: No statistically significant difference in clinical pregnancy rates per cycle initiated was found for patients in the treatment or control group (12% vs 7%, P =.29). Other variables assessed, including endometrial thickness, size of follicles, peak serum estradiol levels, mid-lutea progesterone levels, and total vials of rFSH used also showed no statistically significant difference. CONCLUSION: Superovulation/IUI cycles using Ganirelix produce similar pregnancy rates when compared with cycles not using a GnRH antagonist, although there is a trend towards better pregnancy rates in cycles with Ganirelix.

Conservative management of a uterine tumor resembling an ovarian sex cord-stromal tumor.

BACKGROUND: Sex cord-stromal tumors usually arise in the ovary but may arise in the uterus. Only 55 cases have been reported thus far. A hysterectomy is typically recommended. We report a case of uterine tumor resembling an ovarian sex cord-stromal tumor managed conservatively. CASE: A 32-year-old nulliparous woman presented with infertility secondary to suspected uterine leiomyomata. A laparoscopic resection of the presumed leiomyomata was performed, and the pathology showed a uterine tumor resembling an ovarian sex cord tumor. Because of the patient's desire to preserve fertility, a hysterectomy was not performed. She has been followed for the past 18 months, and there is no evidence of tumor recurrence. CONCLUSION: Resection of the tumor without hysterectomy and close follow-up may preserve fertility without compromising survival in patients with uterine tumors resembling ovarian sex cord-stromal tumors.