title: Serum human chorionic gonadotropin level after ovulation triggering is influenced by the patient's body mass index and the number of larger follicles.
abstract: OBJECTIVE
  To identify determinants of the serum concentration of hCG levels after triggering of ovulation with exogenous hCG during controlled ovarian stimulation cycles for in vitro fertilization with or without intracytoplasmic sperm injection.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  University Medical Center.
  
  
  METHODS
  One hundred-fifteen women who underwent conventional in vitro fertilization/intracytoplasmic sperm injection cycles from March 2003 to March 2005.
  
  
  METHODS
  All patients underwent ovarian hyperstimulation with gonadotropins and GnRH-antagonist for pituitary downregulation. Patients were started on oral contraceptives 1 month before the stimulation. Gonadotropins were administered from stimulation day 1 until the day of the hCG trigger, and GnRH-antagonist was added from the day when at least one follicle reached 14 mm in diameter and continued until hCG administration. The hCG was administered in 5,000-IU, 10,000-IU, or 15,000-IU doses on the day of ovulation triggering.
  
  
  METHODS
  We performed a stepwise multiple regression analysis to predict which variable would influence the serum concentration of hCG when measured the day after the administration of exogenous hCG.
  
  
  RESULTS
  Body mass index (kg/m2) and number of follicles >14 mm were the only determinants of the hCG concentration (cumulative R2 = 0.30; P<.001). Patient age, estradiol peak, number of oocytes retrieved, length of stimulation, and length of GnRH-antagonist administration in days were not associated with serum hCG levels.
  
  
  CONCLUSIONS
  Knowing that the number of larger follicles and the patient's BMI are the major determinants of the hormone's clearance in the body can help in the hCG dose titration during ovarian stimulation.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, and the University Women's Center, Wayne State University School of Medicine, Detroit, Michigan 48201, USA. ldetti@med.wayne.edu
authors.forename: Laura
authors.initials: L
authors.lastname: Detti
authors.forename: Mohamed F M
authors.initials: MF
authors.lastname: Mitwally
authors.forename: Anuradha
authors.initials: A
authors.lastname: Rode
authors.forename: Frank D
authors.initials: FD
authors.lastname: Yelian
authors.forename: Michael
authors.initials: M
authors.lastname: Kruger
authors.forename: Michael P
authors.initials: MP
authors.lastname: Diamond
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Puscheck
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002452:Cell Count; D048429:Cell Size; D006063:Chorionic Gonadotropin / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006080:Ovarian Follicle / Q000166:cytology* / Q000378:metabolism; D010060:Ovulation / Q000097:blood*; D010062:Ovulation Induction / Q000379:methods; D012189:Retrospective Studies
chemical_list: D006063:Chorionic Gonadotropin