Abstract
Objective
To compare the effectiveness of urinary human chorionic gonadotropin (u-hCG) at reduced
doses of 4000 IU and 6000 IU in inducing final oocyte maturation during in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles.
Study design
164 patients with an indication for IVF or ICSI recruited in this randomized, single-blinded
and controlled study in IVF clinic at the Sun Yat-sen Memorial Hospital. Patients
were prospectively randomized to receive 4000 IU (Group A, n = 83) and 6000 IU (Group B, n = 81) of hCG for triggering final oocyte maturation. Number or percentage of mature
oocytes retrieved per patient, fertilization rates, pregnancy rates were the main
outcome measures.
Results
No evidence of statistically significant difference in the number or proportion of
mature oocytes retrieved was observed in both groups. The lower fertilization rate
and significantly lower clinical pregnancy rate were observed in Group A. The ovarian
hyperstimulation syndrome (OHSS) rates in both groups were also similar. In the subgroup
of BMI < 20 kg/m2, fertilization rate were significantly higher in the administration group of hCG
at the dose of 6000 IU when compared with the dose of 4000 IU (82.40% vs. 70.92%, P = 0.017); in contrast, no significant difference in clinical pregnancy rates was observed
in both groups. In the subgroup of BMI 20–25 kg/m2, clinical pregnancy rates were significantly higher in patients treated with hCG
at dose of 6000 IU than patients treated with hCG at dose of 4000 IU (65.3% vs. 35.0%, P = 0.004); however, no significant difference in fertilization rates was observed.
Conclusion
Both doses of u-hCG revealed an equal effect on the induction of final oocyte maturation
in the patients with moderate or high ovarian response; however, the reduced dose
of hCG could result in an obvious impact on clinical pregnancy rates and did not exhibit
an obvious effect on OHSS rates.
Keywords
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Article info
Publication history
Published online: July 29, 2011
Accepted:
July 11,
2011
Received in revised form:
May 26,
2011
Received:
January 19,
2011
Identification
Copyright
© 2011 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
