Administration of human chorionic gonadotropin for in vitro fertilization-embryo transfer based on the serum luteinizing hormone (LH) concentration: the importance of synchronization with endogenous LH rises.
OBJECTIVE
To examine whether synchronized administration of hCG at the onset of the endogenous LH rise promotes successful IVF.


METHODS
A prospective randomized study.


METHODS
In vitro fertilization program at a university hospital.


METHODS
A total of 208 IVF cycles in 148 patients.


METHODS
Serum LH concentrations were measured daily and hMG was administered daily. Independent of follicle size and E2 concentration, hCG was administered as soon as the LH concentration exceeded the J level, defined as the minimum value + (the day 3 value-the minimum value) x 1/3(J group). Alternatively, hCG was administered when the serum LH concentration turned to increase but was still less than the J level, or 1 day after the serum LH concentration exceeded the J level (non-J group).


RESULTS
The rates of total and ongoing pregnancy per cycle were significantly higher in the J group (35.6% and 26.0%, respectively, n = 104) than in the non-J group (21.2% and 12.5%, respectively, n = 104). Pregnancies in the J group were achieved over a wide range of dominant follicle diameters (13 to 25 mm), E2 levels (198 to 1,700 pg/mL; conversion factor to SI units, 3.671), and E2 level per follicle > or = 12 mm (24 to 225 pg/mL per follicle) recorded on the day of hCG administration.


CONCLUSIONS
Synchronized administration of hCG in accordance with endogenous LH rises produces a high rate of pregnancy in IVF.
Jinno
M
M
Department of Obstetrics and Gynecology, Kyorin University, School of Medicine, Mitaka City, Tokyo, Japan.
Ubukata
Y
Y
Hanyu
I
I
Satou
M
M
Yoshimura
Y
Y
Nakamura
Y
Y
D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood*; D008596:Menotropins / Q000627:therapeutic use; D009994:Osmolar Concentration; D006080:Ovarian Follicle / Q000000981:diagnostic imaging; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors; D014463:Ultrasonography
D006063:Chorionic Gonadotropin; D004958:Estradiol; D008596:Menotropins; D007986:Luteinizing Hormone