OHSS病患hCG劑量調降為5000iu並不明顯降低懷孕率

OHSS高危險病患破卵針hCG劑量調降為5000iu並不會降低懷孕率

http://www.sciencedirect.com/science/article/pii/S0015028207001100

Triggering final oocyte maturation using different doses of human chorionic gonadotropin: a randomized pilot study in patients with polycystic ovary syndrome treated with gonadotropin-releasing hormone antagonists and recombinant follicle-stimulating hormone

• Efstratios M. Kolibianakis, M.D., Ph.D.^, , 
• Evangelos G. Papanikolaou, M.D., Ph.D., 
• Herman Tournaye, M.D., Ph.D., 
• Michel Camus, M.D., 
• Andre C. Van Steirteghem, M.D., Ph.D., 
• Paul Devroey,M.D., Ph.D.

• Centre for Reproductive Medicine, Vrije Universiteit Brussel, Brussels, Belgium

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Objective

To evaluate the effect of different human chorionic gonadotropin (hCG) doses on the ongoing pregnancy rates in patients with polycystic ovary syndrome (PCOS).

Design

Prospective, randomized, controlled trial.

Setting

Tertiary university referral center.

Patient(s)

Eighty PCOS patients.

Intervention(s)

Patients were randomized to receive 10,000 IU (n = 28), 5000 IU (n = 26), or 2500 IU (n = 26) of hCG for triggering final oocyte maturation as soon as ≥3 or more follicles of 17 mm or larger were present at ultrasound. Patients were stimulated with recombinant follicle stimulating hormone (FSH) and daily gonadotropin-releasing hormone (GnRH) antagonist, starting on day 6 of stimulation.

Main Outcome Measure(s)

Ongoing pregnancy, fertilization rates.

Result(s)

The median fertilization rates were 52.8%, 65.4%, and 55.6% after administration of 10,000 IU, 5000 IU and 2500 IU, respectively. The ongoing pregnancy rates per PCOS patient receiving hCG were 26.9% (7 of 26), 30.8% (8 of 26) and 34.8% (8 of 23), respectively.

Conclusion(s)

A decrease in the dose of hCG used to trigger final oocyte maturation does not appear to affect adversely the probability of pregnancy in PCOS patients treated by IVF using GnRH antagonists and recombinant FSH, and further testing in future larger-scale trials is recommended.