title: Ovarian stimulation with daily late follicular phase administration of low-dose human chorionic gonadotropin for in vitro fertilization: a prospective, randomized trial.
abstract: OBJECTIVE
  Evaluate the effectiveness of a new ovarian stimulation (OS) protocol before IVF.
  
  
  METHODS
  Prospective clinical randomized trial.
  
  
  METHODS
  Private centers.
  
  
  METHODS
  Three hundred and twenty-three intended-to-treat women candidates for IVF.
  
  
  METHODS
  Patients were divided into three groups and administered the following treatments: group A, recombinant hFSH from day 3 until follicles reached 13-14 mm, when recombinant hFSH was lowered to 75 IU daily and daily injections of 200 IU of hCG and a GnRH antagonist were administered until final maturation; group B, recombinant hFSH and a GnRH antagonist; group C, recombinant hFSH and a GnRH agonist.
  
  
  METHODS
  Primary outcome was the number of mature oocytes. Secondary outcomes included average initial and total recombinant hFSH dosage, serum E2 level on day of ovulation, number of oocytes retrieved, fertilization, number of top-quality embryos, endometrial thickness, implantation rate, pregnancy rate (PR), and incidence of ovarian hyperstimulation syndrome (OHSS).
  
  
  RESULTS
  The numbers of oocytes retrieved, mature oocytes, fertilization, top-quality embryos, and embryos transferred were comparable in all groups. Implantation rate, PR, and incidence of OHSS were also comparable. The total dose of recombinant hFSH was significantly lower in group A (1,674.7 +/- 59.4 IU, vs. 2,197.9 +/- 77.8 IU in group B and 2,156.7 +/- 80.9 IU in group C).
  
  
  CONCLUSIONS
  This new OS protocol permits follicles and oocytes to fully develop, helps generate top-quality embryos, avoids premature ovulation, establishes clinical pregnancies, reduces administration of recombinant hFSH, minimizes costs, and does not increase the chances of OHSS.
authors.affiliation: Huntington Center for Reproductive Medicine, São Paulo, Brazil. paulofiv@terra.com.br
authors.forename: Paulo
authors.initials: P
authors.lastname: Serafini
authors.forename: Isaac
authors.initials: I
authors.lastname: Yadid
authors.forename: Eduardo L A
authors.initials: EL
authors.lastname: Motta
authors.forename: Jose R
authors.initials: JR
authors.lastname: Alegretti
authors.forename: Joyce
authors.initials: J
authors.lastname: Fioravanti
authors.forename: Marcio
authors.initials: M
authors.lastname: Coslovsky
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005498:Follicular Phase / Q000187:drug effects*; D006801:Humans; D006080:Ovarian Follicle / Q000187:drug effects*; D010060:Ovulation / Q000187:drug effects*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D016896:Treatment Outcome
chemical_list: D006063:Chorionic Gonadotropin