Human choriogonadotropin prior to controlled ovarian stimulation and in vitro fertilization 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 Yadid corresponding author

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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 1

Comparison of maternal age and serum measures of FSH, LH, and E2 before ovarian stimulation and doses of r-FSH at start of stimulation and amount used in both groups. Values are means ± SD

	D1-hCG	Control	P value
Maternal age	34.7±3.9	34.5±4.3	0.8
FSH (IU/ml)	5.9 ±3.5	6.8±2.6	0.5
LH (IU/ml)	4.6±3.1	4.9±1.4	0.8
E2 (pg/ml)	42.9±31.4	32.0±17.6	0.3
Initial r-FSH dose (IU/day)	221.7±6.7	231.8±8.0	0.9
Total r-FSH used (IU/COH)	1,731±722	2,096±704*	<0.05

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

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2013年6月17日

月經第一天施打hCG可提高IVF胚胎著床率