Reducing the trigger dose of recombinant hCG in high-responder patients attending an assisted reproductive technology program: an observational study.
Decreasing the dose of human chorionic gonadotropin (hCG) used to trigger final oocyte maturation in assisted reproductive technology programs is regarded as a useful intervention in the prevention of ovarian hyperstimulation syndrome, but the minimal effective dose has not been yet identified. In this study, the capacity of a reduced dose of recombinant hCG (r-hCG) to provide adequate oocyte maturation was tested for the first time. Thirty-five high-responder patients received a dose of 125 µg (half of the standard dose) of r-hCG for triggering final oocyte maturation. The number of oocytes retrieved per patient and the proportion of mature oocytes were evaluated. As a result, a mean number of 14 oocytes were retrieved, of which 85% were found to be mature (MII). There was only one patient developing a moderate form of ovarian hyperstimulation syndrome and not requiring hospitalization. It is suggested that r-hCG at 125 µg can be effective in triggering final oocyte maturation in high-responder patients. Additional properly powered and controlled studies are needed to support this contention.
Department of Medicine and Aging Sciences, University "G d'Annunzio" of Chieti-Pescara, Chieti, Italy.
Gian Mario
GM
Tiboni
Department of Medicine and Aging Sciences, University "G d'Annunzio" of Chieti-Pescara, Chieti, Italy.
Enrica Concetta
EC
Colangelo
Department of Medicine and Aging Sciences, University "G d'Annunzio" of Chieti-Pescara, Chieti, Italy.
Adalisa
A
Ponzano
D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage* / Q000009:adverse effects; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005298:Fertility / Q000187:drug effects*; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D050498:Live Birth; D054315:Oocyte Retrieval; D009865:Oocytes / Q000187:drug effects*; D016471:Ovarian Hyperstimulation Syndrome / Q000139:chemically induced / Q000517:prevention & control; D010062:Ovulation Induction / Q000009:adverse effects / Q000379:methods*; D010865:Pilot Projects; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage; D012307:Risk Factors; D020554:Sperm Injections, Intracytoplasmic; D016896:Treatment Outcome
D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D011994:Recombinant Proteins
OHSS; low dose; recombinant hCG; triggering oocyte maturation