Effects of the ovulatory serum concentration of human chorionic gonadotropin on the incidence of ovarian hyperstimulation syndrome and success rates for in vitro fertilization.
OBJECTIVE
To determine whether the serum concentration of hCG on the day after hCG administration (abbreviated throughout this article as [hCG]) is related to the incidence of ovarian hyperstimulation syndrome (OHSS), oocyte recovery per follicle, fertilization, blastulation, embryo transfer, implantation, and clinical pregnancy.


METHODS
Retrospective study.


METHODS
Private infertility clinic.


METHODS
The OHSS study group included 849 non-donor IVF cycles performed between January 1998 and August 2003. The study group for hCG efficacy included 248 nondonor IVF cycles performed between January 2001 and May 2003 with patients younger than 35 years of age.


METHODS
None.


METHODS
Occurrence of OHSS, severity of OHSS, [hCG], proportion of follicles yielding oocytes, fertilization rate, blastulation rate, transfer rate, implantation rate, and clinical pregnancy rate.


RESULTS
No significant relationships were observed between [hCG] and the proportion of follicles yielding oocytes, fertilization rate, blastulation rate, or the probabilities of embryo transfer, implantation, or clinical pregnancy. The incidence of OHSS (all types) and OHSS requiring transvaginal paracentesis were predicted by [hCG] (P=.02 and P=.05, respectively) and with follicle count (P<.0001 in both cases).


CONCLUSIONS
These results suggest that moderated hCG dosage is useful in preventing OHSS without reducing efficacy.
Shapiro
Bruce S
BS
Fertility Center of Las Vegas, Las Vegas, Nevada, USA. bsshapiro@aol.com
Daneshmand
Said T
ST
Garner
Forest C
FC
Aguirre
Martha
M
Ross
Richard
R
Morris
Suzanne
S
D000328:Adult; D016009:Chi-Square Distribution; D006063:Chorionic Gonadotropin / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D016471:Ovarian Hyperstimulation Syndrome / Q000097:blood* / Q000453:epidemiology*; D010053:Ovary / Q000378:metabolism; D010062:Ovulation Induction / Q000379:methods / Q000706:statistics & numerical data*; D011247:Pregnancy; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
D006063:Chorionic Gonadotropin