Publication:

Use of clomiphene to prevent premature luteinizing hormone surge during controlled ovarian hyper stimulation

Background This study seeks to evaluate concurrent use of clomiphene to block spontaneous LH surge in controlled ovarian stimulation in patients with good ovarian reserve.

Methods Thirty five fertile donors with good antral count were stimulated from day 1 or 2 of spontaneous or withdrawal bleeds with clomiphene citrate and recombinant FSH. Transvaginal oocyte retrieval was done after 34 hours of trigger.   An LH surge was defined as an LH level ≥10 mIU/ml with progesterone elevation (≥1.0 ng/ml). Fertilization and Embryo quality was assessed from day 2 onwards. Each recipient was transferred a maximum of 3 embryos and remaining were cryopreserved.

Results After an average stimulation of 8.65 days, 15.4 oocytes were retrieved per stimulation. LH surge was noted in 3 cases (9.68%) though oocyte retrieval was done in all cases. Fresh embryo transfer was done in respective recipients of all cases with an implantation rate of 61.29% and a cumulative live birth rate of 42%.

Conclusions Controlled ovarian stimulation using clomiphene and gonadotropin is a viable option to prevent LH surge without additional use of antagonist.