Efficacy of low-dose human chorionic gonadotropin alone to complete controlled ovarian stimulation.
OBJECTIVE
To prove that low-dose hCG alone can be clinically used to replace FSH-containing gonadotropins to complete controlled ovarian hyperstimulation (COH).


METHODS
Controlled, prospective, randomized study.


METHODS
Academic center.


METHODS
Infertile patients who are candidates for assisted reproduction.


METHODS
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).


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Filicori
Marco
M
Reproductive Endocrinology Center, University of Bologna, Bologna, Italy. marco.filicori@unibo.it
Cognigni
Graciela Estela
GE
Gamberini
Elena
E
Parmegiani
Lodovico
L
Troilo
Enzo
E
Roset
Brunilde
B
D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000188:drug therapy; D006080:Ovarian Follicle / Q000187:drug effects* / Q000378:metabolism; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018709:Statistics, Nonparametric
D006063:Chorionic Gonadotropin; D005640:Follicle Stimulating Hormone