title: Follicle-stimulating hormone administered at the time of human chorionic gonadotropin trigger improves oocyte developmental competence in in vitro fertilization cycles: a randomized, double-blind, placebo-controlled trial.
abstract: OBJECTIVE
  To determine whether an additional follicle-stimulating hormone (FSH) bolus administered at the time of the human chorionic gonadotropin (hCG) trigger can improve the developmental competence of the oocyte.
  
  
  METHODS
  Randomized, double-blind, placebo-controlled, clinical trial.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Women undergoing a long agonist suppression in vitro fertilization (IVF) protocol for treatment of infertility.
  
  
  METHODS
  FSH bolus at time of hCG trigger versus placebo.
  
  
  METHODS
  Primary outcome; fertilization; secondary outcomes: oocyte recovery, implantation rate, and clinical and ongoing pregnancy/live birth rates.
  
  
  RESULTS
  A total of 188 women (mean age: 36.2 years; range: 25 to 40 years) were randomized. Fertilization (2PN/#oocyte) was statistically significantly improved in the treatment arm (63% vs. 55%) as was the likelihood of oocyte recovery (70% vs. 57%). There was no statistically significant difference in clinical pregnancy rate (56.8% vs. 46.2%) or ongoing/live birth rate (51.6% vs. 43.0%).
  
  
  CONCLUSIONS
  Improvements in IVF success rates have largely been due to optimization of embryo culture and stimulation protocols; less attention has been directed toward methods to improve induction of final oocyte maturation. This was the first randomized, double-blind, placebo-controlled trial to modify the ovulation trigger to improve oocyte competence, as demonstrated by the statistically significant improvement in fertilization.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Reproductive Endocrinology and Infertility, University of California, San Francisco, California 94115, USA.
authors.forename: Julie D
authors.initials: JD
authors.lastname: Lamb
authors.forename: Shehua
authors.initials: S
authors.lastname: Shen
authors.forename: Charles
authors.initials: C
authors.lastname: McCulloch
authors.forename: Liza
authors.initials: L
authors.lastname: Jalalian
authors.forename: Marcelle I
authors.initials: MI
authors.lastname: Cedars
authors.forename: Mitchell P
authors.initials: MP
authors.lastname: Rosen
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D047108:Embryonic Development / Q000187:drug effects*; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D006801:Humans; D009865:Oocytes / Q000187:drug effects* / Q000502:physiology; D009866:Oogenesis / Q000187:drug effects; D010062:Ovulation Induction / Q000379:methods*; D010507:Periodicity; D010919:Placebos; D011247:Pregnancy
chemical_list: D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D010919:Placebos; D005640:Follicle Stimulating Hormone