Efficacy of a single injection of human chorionic gonadotropin at peak follicular maturation in natural cycles on pregnancy rate and mid-luteal hormonal and sonographic parameters.
OBJECTIVE
To discover if infertile women with presumed luteal phase deficiency would improve pregnancy rates, mid-luteal sera estradiol (E2) and progesterone (P), and increase the percentage of women achieving a mid-luteal sonographic homogeneous hyperechogenic endometrial texture by the addition of a single injection of human chorionic gonadotropin (hCG).


METHODS
Women with over one year of infertility with regular menses and with no other known infertility factor were presumed to have the need for extra P in the luteal phase based on previous studies. Women aged ≥ 30 years were selected along with women < 30 years who had pelvic pain or dysmenorrhea. Women aged 40-45 were evaluated separately. They were treated with either vaginal micronized P 8% twice daily alone or 10,000 units of hCG at the time of peak follicular maturation was also given. Women were eliminated if they did not achieve an 18-24 average diameter follicle with a serum E2 of > 200 pg/ml. Seven days after ovulation, sera E2 and P were measured along with endometrial thickness and echo patterns.


RESULTS
The only significant difference between groups was an increased mid-luteal serum E2 in the group receiving additional hCG. However, this did not result in an increased pregnancy rate.


CONCLUSIONS
In general, adding a single injection of hCG to P luteal support does not improve pregnancy rates in natural cycles where women were treated with supplemental P.
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D000282:Administration, Intravaginal; D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D004717:Endometrium / Q000000981:diagnostic imaging*; D004958:Estradiol / Q000097:blood*; D005260:Female; D007987:Gonadotropin-Releasing Hormone; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy*; D007267:Injections; D008183:Luteal Phase / Q000097:blood*; D006080:Ovarian Follicle; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000097:blood / Q000627:therapeutic use*; D011372:Progestins / Q000627:therapeutic use*; D012102:Reproductive Control Agents / Q000008:administration & dosage*; D014463:Ultrasonography
D006063:Chorionic Gonadotropin; D011372:Progestins; D012102:Reproductive Control Agents; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D004958:Estradiol