月經第一天1使用HCG再誘導排卵可減少FSH劑量, 提升懷孕率

IVF+GnHR antagonist病人，誘導排卵前(月經第一天1)使用HCG (Ovidrel, 250 μg)
可減少FSH劑量(1731 vs 2096 iu), 提升胚胎品質, 著床率

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729860/

J Assist Reprod Genet. 2009 June; 26(6): 305–311.

Published online 2009 June 16. doi:  10.1007/s10815-009-9322-x

PMCID: PMC2729860

Human choriogonadotropin prior to controlled ovarian stimulation and in vitrofertilization improves implantation, and pregnancy rates

Eduardo L. Motta,1,2,4 Gary D. Smith,5,6,7,8 Paulo C. Serafini,1,2,3 Marcio Coslovsky,1 Pericles Hassun,9 Andre M. Rocha,1,2 and Isaac Yadid1

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Abstract

Purpose

Our purpose was to retrospectively compare controlled ovarian stimulation(COH) in IVF cycles with administration of hCG on the day of menses (D1-hCG) with women not receiving hCG at day 1 of menses (Control).

Methods

Data on maternal age, endocrine profile, amount of rFSH required, embryo characteristics, implantation and pregnancy rates were recorded for comparison between D1-hCG (n=36) and Control (n=64).

Results

Dose of rFSH required to accomplish COH was significantly lower in D1-hCG. Following ICSI, more top-quality embryos were available for transfer per patient in the D1-hCG and biochemical pregnancy rates per transfer were significantly higher in the D1-hCG. Significantly higher implantation and on-going pregnancy rates per embryo transfer were observed in D1-hCG (64%) compared to Control (41%).

Conclusions

Administration of D1-hCG prior to COH reduces rFSH use and enhances oocyte developmental competence to obtain top quality embryos, and improves implantation and on-going pregnancy rates. At present it is not clear if the benefit is related to producing an embryo that more likely to implant or a more receptive uterus, or merely fortuitous and related to the relatively small power of the study.

Table 3

Comparison of embryos transferred, biochemical and on-going pregnancy rates, and implantation rates following controlled ovarian hyperstimulation with exogenous hormones in women treated with D1-hCG or Controls

	D1-hCG	Control	P value
Embryos transferred (mean ± SD)	3.5±1.1	3.6±1.1	0.7
Biochemical pregnancy/ET (%)	67*	41	0.02
On going pregnancy/ET (%)	64*	41	0.04
Implantation (%)	33*	21	0.03
Birth/ET(%)	47	34	0.2
Abortion/ET (%)	16	6	0.1
Multiples/pregnancies (%)	23	27	0.7