Rescue of corpus luteum function with peri-ovulatory HCG supplementation in IVF/ICSI GnRH antagonist cycles in which ovulation was triggered with a GnRH agonist: a pilot study.
Previous studies found a poor clinical outcome when a GnRH agonist (GnRHa) was used to trigger ovulation in GnRH antagonist IVF/ICSI cycles. This study aimed to determine the clinical and endocrine effects as well the optimal timing of HCG supplementation. Forty-five normogonadotrophic IVF/ICSI patients following a flexible antagonist protocol were prospectively randomized (sealed envelopes) to triggering of ovulation with a single bolus of either 10,000 IU of HCG (group 1, n = 15) or 0.5 mg buserelin s.c. In addition, the GnRHa triggered group was randomized into two groups: group 2 (n = 17) was supplemented with HCG 1500 IU, 12 h after ovulation induction and group 3 (n = 13) was supplemented with HCG 1500 IU 35 h after ovulation induction. Group 1 and group 3 had significantly higher luteal phase concentrations of progesterone (P < 0.001) as compared with group 2. Moreover, the clinical pregnancy rate of groups 1 and 3 was similar and significantly higher (P < 0.02) than that of group 2. A larger study, however, is required to substantiate these differences. No differences were seen regarding mid-luteal inhibin A concentrations between the three groups. Triggering of ovulation with GnRHa supplemented with 1500 IU HCG 35 h later (group 3) seems to secure a normal luteal phase and a normal clinical pregnancy outcome.
Humaidan
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P
The Fertility Clinic, Viborg Hospital (Skive), DK 7800 Skive, Denmark. peter.humaidan@sygehusviborg.dk
Bungum
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L
Bungum
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M
Yding Andersen
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C
D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000627:therapeutic use*; D003338:Corpus Luteum / Q000187:drug effects* / Q000502:physiology; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage / Q000627:therapeutic use*; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000819:agonists* / Q000031:analogs & derivatives / Q000037:antagonists & inhibitors* / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy; D007265:Inhibins / Q000097:blood; D010060:Ovulation / Q000187:drug effects*; D010062:Ovulation Induction; D010865:Pilot Projects; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000097:blood; D020554:Sperm Injections, Intracytoplasmic
D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; C422362:inhibin A; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D007265:Inhibins; C083781:LHRH, Ala(6)-Gly(10)-ethylamide-