title: Triggering final oocyte maturation with reduced doses of hCG in IVF/ICSI: a prospective, randomized and controlled study.
abstract: OBJECTIVE
  To compare the effectiveness of urinary human chorionic gonadotropin (u-hCG) at reduced doses of 4000 IU and 6000 IU in inducing final oocyte maturation during in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles.
  
  
  METHODS
  164 patients with an indication for IVF or ICSI recruited in this randomized, single-blinded and controlled study in IVF clinic at the Sun Yat-sen Memorial Hospital. Patients were prospectively randomized to receive 4000 IU (Group A, n=83) and 6000 IU (Group B, n=81) of hCG for triggering final oocyte maturation. Number or percentage of mature oocytes retrieved per patient, fertilization rates, pregnancy rates were the main outcome measures.
  
  
  RESULTS
  No evidence of statistically significant difference in the number or proportion of mature oocytes retrieved was observed in both groups. The lower fertilization rate and significantly lower clinical pregnancy rate were observed in Group A. The ovarian hyperstimulation syndrome (OHSS) rates in both groups were also similar. In the subgroup of BMI< 20 kg/m(2), fertilization rate were significantly higher in the administration group of hCG at the dose of 6000 IU when compared with the dose of 4000 IU (82.40% vs. 70.92%, P=0.017); in contrast, no significant difference in clinical pregnancy rates was observed in both groups. In the subgroup of BMI 20-25 kg/m(2), clinical pregnancy rates were significantly higher in patients treated with hCG at dose of 6000 IU than patients treated with hCG at dose of 4000 IU (65.3% vs. 35.0%, P=0.004); however, no significant difference in fertilization rates was observed.
  
  
  CONCLUSIONS
  Both doses of u-hCG revealed an equal effect on the induction of final oocyte maturation in the patients with moderate or high ovarian response; however, the reduced dose of hCG could result in an obvious impact on clinical pregnancy rates and did not exhibit an obvious effect on OHSS rates.
authors.affiliation: Department of Gynecology & Obstetrics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Lin
authors.forename: Wenjun
authors.initials: W
authors.lastname: Wang
authors.forename: Yu
authors.initials: Y
authors.lastname: Li
authors.forename: Xianghong
authors.initials: X
authors.lastname: Chen
authors.forename: Dongzi
authors.initials: D
authors.lastname: Yang
authors.forename: Qingxue
authors.initials: Q
authors.lastname: Zhang
mesh_terms: D000328:Adult; D015992:Body Mass Index; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004624:Embryo Transfer; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D005307:Fertilization in Vitro; D006801:Humans; D007246:Infertility / Q000628:therapy*; D009866:Oogenesis / Q000187:drug effects*; D010044:Outpatient Clinics, Hospital; D016471:Ovarian Hyperstimulation Syndrome / Q000517:prevention & control; D010062:Ovulation Induction / Q000379:methods*; D010446:Peptide Fragments / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D011247:Pregnancy; D018873:Pregnancy Rate; D016037:Single-Blind Method; D020554:Sperm Injections, Intracytoplasmic; D055815:Young Adult
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D005300:Fertility Agents, Female; D010446:Peptide Fragments; C063554:urinary gonadotropin fragment