Efficacy of low-dose human chorionic gonadotropin alone to complete controlled ovarian stimulation.

Abstract:

OBJECTIVE:To prove that low-dose hCG alone can be clinically used to replace FSH-containing gonadotropins to complete controlled ovarian hyperstimulation (COH). DESIGN:Controlled, prospective, randomized study. SETTING:Academic center. PATIENT(S):Infertile patients who are candidates for assisted reproduction. INTERVENTION(S):Patients received [1] recombinant FSH or hMG throughout COH (group A); [2] ovarian priming with recombinant FSH/hMG followed by low-dose hCG (200 IU/day) alone (group B). MAIN OUTCOME MEASURE(S):Medication consumption; daily serum and follicular fluid (FF) measurements of LH, FSH, hCG, E2, P, T, and androstenedione (A); number and size of follicles; intracytoplasmic sperm injection (ICSI) outcome. RESULT(S):In group B: [1] duration and dose of recombinant FSH/hMG administration were reduced; [2] preovulatory serum hCG, E2, and T were higher, whereas FSH was lower; [3] FF hCG, E2, T levels, and E2/T, E2/A, and E2/P ratios were higher, whereas A was lower; [4] small but not large preovulatory follicles were reduced; [5] fertilization rates were higher; and [6] serum and FF P levels, and ICSI outcome did not differ. CONCLUSION(S):Low-dose hCG alone in the late COH stages: [1] reduced recombinant FSH/hMG consumption whereas ICSI outcome was comparable to traditional COH regimens; [2] stimulated follicle growth and maturation independent of FSH administration; [3] was associated with a reduced number of small preovulatory follicles; [4] did not cause premature luteinization; [5] resulted in a more estrogenic intrafollicular environment.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Filicori M,Cognigni GE,Gamberini E,Parmegiani L,Troilo E,Roset B

doi

10.1016/j.fertnstert.2005.02.036

keywords:

subject

Has Abstract

pub_date

2005-08-01 00:00:00

pages

394-401

issue

2

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(05)01030-7

journal_volume

84

pub_type

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