腦下垂體拮抗劑誘導排卵HCG 施打時機

使用腦下垂體拮抗劑gonadotropin-releasing hormone antagonists施行試管嬰兒誘導排卵，HCG 施打時機3顆卵子>1.6cm當天施打HCG(early-hCG group)
3顆卵子>1.6cm後24h施打HCG (late-hCG group)
二組懷孕率&活產率 無統計差異
較早施打HCG 並沒較好之臨床效果

from: http://www.ncbi.nlm.nih.gov/pubmed/21924414

Fertil Steril. 2011 Nov;96(5):1112-5. Epub 2011 Sep 15.

Is earlier administration of human chorionic gonadotropin (hCG) associated with the probability of pregnancy in cycles stimulated with recombinant follicle-stimulating hormone and gonadotropin-releasing hormone (GnRH) antagonists? A prospective randomized trial.

Kyrou D, Kolibianakis EM, Fatemi HM, Tarlatzis BC, Tournaye H, Devroey P.

Source

Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.

Abstract

OBJECTIVE:

To evaluate the association of timing of hCG administration and probability of pregnancy in patients stimulated with recombinant FSH/GnRH antagonists for IVF.

DESIGN:

Prospective randomized controlled clinical trial.

SETTING:

Dutch-speaking Free University of Brussels.

PATIENT(S):

One hundred twenty patients, aged <40 years, treated by IVF or intracytoplasmic sperm injection.

INTERVENTION(S):

Ovarian stimulation was achieved using recombinant FSH starting on day 2 of the menstrual cycle at a fixed dose. To inhibit premature LH surge, daily GnRH antagonist was used from day 6 of stimulation. Triggering of final oocyte maturation was performed using 10,000 IU of hCG. Patients were randomized to receive hCG either as soon as three or more follicles of size ≥16 mm were present on ultrasonography (early-hCG group) or 1 day after the above criterion was met (late-hCG group).

MAIN OUTCOME MEASURE(S):

Ongoing pregnancy rate.

RESULT(S):

Significant differences were observed between the early-hCG and the late-hCG group regarding E(2) (1,388 ± 931 [mean ± SD] vs. 2,040 ± 1,231 pg/mL, respectively) and P (0.8 ± 0.3 vs. 1.1 ± 0.5 ng/mL, respectively) levels on the day of hCG administration and the number of metaphase II oocytes (9.2 ± 7.1 vs. 6.1 ± 4.9, respectively). No significant differences were observed between the early-hCG and the late-hCG group regarding positive hCG (46.2% vs. 50%, respectively) and ongoing pregnancy rates (34.6% vs. 40.7%, respectively).

CONCLUSION(S):

The current study provides evidence that earlier administration of hCG is not associated with the probability of pregnancy in cycles stimulated with recombinant FSH and GnRH antagonists.