Dynamics of the development of multiple follicles by early versus late hCG administration in ART program.
OBJECTIVE
To evaluate, in patients stimulated with recombinant FSH and GnRH antagonists, whether triggering the final maturation of oocytes affects IVF outcomes.


METHODS
Five hundred and six IVF procedures were divided into three groups according to the timing of hCG administration: when at least 2 follicles reached the diameter of 17 mm, at least 2 follicles reached 18 mm and at least 2 follicles reached 20 mm. The main outcome was the number of mature oocyte that was the dependent variable of a multivariate model whose independents were, age, AFC, hCG timing, E2 levels at hCG day, number of follicles in different categories of dimension. Secondary endpoints were to compare fertilization, implantation and pregnancy rates in a multilevel multivariate model whose covariates were age, BMI, AFC, embryo quality and cause of infertility.


RESULTS
Timing did not result a statistically significant factor influencing the number of oocytes collected, which was influenced by age, AFC, number of follicles between 12.1 and 15.9 mm and E2 levels. Implantation rate and pregnancy rate appear to be affected only by embryo quality.


CONCLUSIONS
The number of oocytes collected and the probability of pregnancy are not associated with the time of hCG administration.
a Unit of Pathophysiology of Human Reproduction and Gametes Cryopreservation, Department of General Surgery , Gynecology, Obstetrics and Anesthesiology, University Hospital of Bari, Consorziale Policlinico , Bari , Italy , and.
Maddalena
M
Falagario
b Department of Biomedical Science and Human Oncology , University of Bari. Medical School , Bari , Italy.
Paolo
P
Trerotoli
a Unit of Pathophysiology of Human Reproduction and Gametes Cryopreservation, Department of General Surgery , Gynecology, Obstetrics and Anesthesiology, University Hospital of Bari, Consorziale Policlinico , Bari , Italy , and.
Annarosa
A
Chincoli
a Unit of Pathophysiology of Human Reproduction and Gametes Cryopreservation, Department of General Surgery , Gynecology, Obstetrics and Anesthesiology, University Hospital of Bari, Consorziale Policlinico , Bari , Italy , and.
Isabella
I
Cobuzzi
a Unit of Pathophysiology of Human Reproduction and Gametes Cryopreservation, Department of General Surgery , Gynecology, Obstetrics and Anesthesiology, University Hospital of Bari, Consorziale Policlinico , Bari , Italy , and.
Margherita P
MP
Vacca
a Unit of Pathophysiology of Human Reproduction and Gametes Cryopreservation, Department of General Surgery , Gynecology, Obstetrics and Anesthesiology, University Hospital of Bari, Consorziale Policlinico , Bari , Italy , and.
Doriana
D
Falagario
a Unit of Pathophysiology of Human Reproduction and Gametes Cryopreservation, Department of General Surgery , Gynecology, Obstetrics and Anesthesiology, University Hospital of Bari, Consorziale Policlinico , Bari , Italy , and.
Claudia
C
Nardelli
a Unit of Pathophysiology of Human Reproduction and Gametes Cryopreservation, Department of General Surgery , Gynecology, Obstetrics and Anesthesiology, University Hospital of Bari, Consorziale Policlinico , Bari , Italy , and.
Raffaella
R
Depalo
D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D009865:Oocytes / Q000502:physiology*; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D018873:Pregnancy Rate; D012102:Reproductive Control Agents / Q000008:administration & dosage / Q000494:pharmacology*; D013997:Time Factors
D006063:Chorionic Gonadotropin; D012102:Reproductive Control Agents
hCG administration; hCG timing; mature oocytes; pick up timing