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The effect of low dose human chorionic gonadotropin on follicular response and oocyte maturation in PCOS patients undergoing IVF cycles: a randomized clinical trial of efficacy and safety

  • General Gynecology
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Abstract

Purpose

To compare the efficacy of two regimens of low dose human chorionic gonadotropin (hCG) on follicular response and oocyte maturation in women with polycystic ovarian syndrome (PCOS).

Methods

Ninety women with PCOS who underwent assisted reproduction were eligible for this controlled, prospective, randomized study. Our trial was performed at Royan Institute Reproductive Research Center over a 24-month period. Ovarian stimulation in all groups was initiated with recombinant FSH, 150 IU daily. The dose and duration of FSH treatment were adjusted by monitoring follicular development with ultrasound and estradiol levels. Patients were randomized using a block randomization technique which assigned them to three groups: group A (control group) continued r-FSH until oocyte retrieval. In group B, r-FSH was reduced to 75 IU once the lead follicle reached 14 mm in mean diameter and low dose hCG (100 IU/day) was initiated. In group C, r-FSH was discontinued and low dose hCG (200 IU/day) was begun when the lead follicle reached 14 mm in mean diameter. The main outcome measure was follicular response and oocyte maturation.

Results

As compared to the FSH only group, groups which were given low dose hCG had lower gonadotropin consumption and fewer immature oocytes than the control group. No women in the low dose hCG groups developed severe ovarian hyper-stimulation syndrome. Fertilization, implantation and pregnancy rates were similar in the three groups.

Conclusions

A combination of FSH and low dose hCG improved oocyte maturity and preserved outcomes with improved safety and lowered cost.

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Acknowledgments

The authors gratefully thank all the couples who participated in the study and the co-workers of the Royan Institute of Infertility and Reproductive Health, which would have been impossible without their contributions.

Conflict of interest

We declare that we have no conflict of interest in this study.

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Authors and Affiliations

  1. Department of Endocrinology and Female Infertility, Royan Institute for Reproductive Biomedicine, ACECR, P.O. Box 19395-4644, Number 12, East Hafez Avenue, Bani Hashem Street, Resalat Highway, Tehran, Iran

    Mahnaz Ashrafi, Kiandokht Kiani & Fatemeh Rastegar

  2. Department of Obstetrics and Gynecology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran

    Mahnaz Ashrafi & Afsaneh Ghasemi

  3. Department of Epidemiology and Reproductive Health, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran

    Maryam Nabavi

Authors
  1. Mahnaz Ashrafi
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  2. Kiandokht Kiani
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  3. Afsaneh Ghasemi
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  4. Fatemeh Rastegar
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  5. Maryam Nabavi
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Corresponding author

Correspondence to Kiandokht Kiani.

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Ashrafi, M., Kiani, K., Ghasemi, A. et al. The effect of low dose human chorionic gonadotropin on follicular response and oocyte maturation in PCOS patients undergoing IVF cycles: a randomized clinical trial of efficacy and safety. Arch Gynecol Obstet 284, 1431–1438 (2011). https://doi.org/10.1007/s00404-010-1827-0

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  • DOI: https://doi.org/10.1007/s00404-010-1827-0

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