GnRH antagonist administration to postpone a weekend intrauterine insemination: a large cohort study from a public center.

BACKGROUND: In Spanish public hospital Reproduction Units it is very problematic to perform programmed intrauterine insemination (IUI) on weekends, if indicated. Small previous pilot studies suggest that using a GnRH antagonist to avoid an LH weekend surge would allow to perform IUI on the following Monday, not impairing the expected pregnancy rate. METHODS: Between 1st January 2007 and 31st December 2015, 4.782 intrauterine inseminations were performed at Valladolid University Clinic, Spain, corresponding to 1.650 women. Of them, 911, corresponding to 695 women, should ideally have been performed during the weekend. If it happened that a member of the Reproduction Unit was on duty during that particular weekend, the standard protocol was not interrupted, and the IUI performed as planned (control group, 685 IUIs). If the former was not the case, the weekend gap was bridged by administering 0.25 mg GnRH antagonist (GnRHa). Ovulation was induced by means of 250 ug recombinant HCG (rHCG) 36 h prior to IUI on the following Monday (study group, 226 IUIs). RESULTS: There were no differences in the clinical pregnancy rate (13.7 cc vs. 16.2 %, p = 0.371) or in the ongoing pregnancy rate between groups (11.9 % vs. 14.9 %, p = 0.271). The multiple pregnancy rate was also comparable in both groups (14.7 % vs. 18.5 %, p = 0.77). CONCLUSIONS: Women with a planned IUI which cannot be performed at the ideal date can be offered postponement for two days with the support of GnRHa treatment, with results that are not inferior to those expected applying the regular protocol.

Ovarian hydatid disease.

Hydatid disease, also known as Echinococcosis is a zoonosis caused by the larval stage of Echinococcus. The human cystic variant primarily affects liver and lungs. The pelvic location of the disease is a rare finding usually secondary to a ruptured liver cyst, although it may also appear as a primary lesion affecting the genital organs. Despite its rarity, in endemic areas, pelvic hydatid disease should be considered in the differential diagnosis of complex adnexal cystic mass, to make an appropriate treatment strategy. The suspected diagnosis is based on imaging studies and serodiagnostic techniques, in which a new field of research attempts to find a standardized test with sufficient sensitivity and specificity. We report a case of primary pelvic hydatid disease in postmenopausal women operated for suspected ovarian cancer.