title: Substituting human chorionic gonadotropin by gonadotropin-releasing hormone agonist to trigger final follicular maturation, during controlled ovarian hyperstimulation, results in less systemic inflammation.
abstract: BACKGROUND
  To investigate the degree of systemic inflammation, as reflected by serum C-reactive protein (CRP) levels, associated with controlled ovarian hyperstimulation (COH) with human chorionic gonadotropin (hCG) or gonadotropin-releasing hormone (GnRH) agonist for the induction of final follicular maturation.
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  An in vitro fertilization (IVF) unit of an academic medical center.
  
  
  METHODS
  Twenty-four women undergoing COH and IVF with the flexible GnRH antagonist protocol were prospectively assigned to receive hCG or GnRH agonist for the induction of final follicular maturation.
  
  
  METHODS
  Blood was drawn three times during COH for measurement of sex-steroid and CRP levels: the day on which adequate suppression was obtained (Day-0); the day of or prior to administration of hCG (Day-hCG); and (3) the day of ovum pick-up (Day-OPU). Levels were compared among the three time points in the two groups.
  
  
  RESULTS
  No between-group differences were observed in terms of patient age, gonadotropin dosage, duration of stimulation or number of oocytes retrieved. Serum CRP levels were significantly higher on Day-OPU than on Day-hCG and Day-0, but the difference was significant only in the hCG group (p<0.03 for both). The percentage change in CRP levels after hCG administration (Day-OPU vs. Day-hCG) (96%) was higher than that after GnRH administration (23%).
  
  
  CONCLUSIONS
  Administration of GnRH agonist in patients undergoing COH for IVF yields a lesser degree of systemic inflammation, as reflected by CRP levels, than hCG.
authors.affiliation: Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tiqwa and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. raoulo@barzi.health.gov.il
authors.forename: Raoul
authors.initials: R
authors.lastname: Orvieto
authors.forename: Irina
authors.initials: I
authors.lastname: Zagatsky
authors.forename: Vered
authors.initials: V
authors.lastname: Yulzari-Roll
authors.forename: Antonio
authors.initials: A
authors.lastname: La Marca
authors.forename: Benjamin
authors.initials: B
authors.lastname: Fisch
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D002452:Cell Count; D006063:Chorionic Gonadotropin / Q000494:pharmacology*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D005498:Follicular Phase / Q000187:drug effects*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006062:Gonadotropins / Q000627:therapeutic use; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D010062:Ovulation Induction / Q000009:adverse effects* / Q000379:methods*; D010063:Ovum / Q000166:cytology / Q000187:drug effects
chemical_list: D006063:Chorionic Gonadotropin; D006062:Gonadotropins; D007987:Gonadotropin-Releasing Hormone; D002097:C-Reactive Protein