Objective To compare the results of a novel regimen of human menopausal gonadotrophin (hMG) in combination with clomiphene citrate (CC) in mid-to-late follicular phase with those of a short protocol of GnRH agonist (GnRHa) and hMG used for IVF. Methods In the retrospective study, 842 patients undergoing IVF were collected and classified into two groups: hMG in combination with CC in mid-to-late follicular phase (group A, n=319) and short protocol of GnRHa-hMG (group B, n=523). The main outcome measures were ovarian responses in stimulation cycles and pregnancy outcomes in subsequent frozen-thawed embryo transfer (FET) cycles. Results In group A, the serum LH concentration on day 8-10 was similar with that on the day of hCG administration (2.43 ± 1.92 IU vs 2.51 ± 2.05 IU). The number of mature follicles and oocytes retrieved was significantly lower in group A than in group B while the fertilization rate and the cleavage rate were comparable. The clinical pregnancy rate (47.79% vs 48.04%), the implantation rate (32.49% vs 33.11%) and the cumulative pregnancy rate (58.09% vs 60.22%) were respectively similar in group A and group B. Conclusion hMG in combination with CC in mid-to-late follicular phase results in the same pregnancy outcome as short protocol. The novel protocol may take the advantage of eliminating the occurrence of a premature endogenous LH surge.
Yan KANGQing-qing HONGWei-ran CHAIYong-lun FUAi AIQiu-ju CHENYan-ping KUANG
Objective To compare the efficacy of human chorionic gonadotrophin(hCG) at reduced doses of 2 000 IU and 3 000 IU for moderate or high responders with the dose of 5 000 IU in term of inducing final oocyte maturation for IVF/ICSI and the subsequent pregnancy outcome in frozen-thawed embryo transfer(FET).Methods In the retrospective cohort study,2 166 patients undergoing IVF/ICSI with moderate or high response were recruited and classified into three groups according to the trigger dose of hCG:2 000 IU(group A,n=722),3 000 IU(group B,n=722)and 5 000 IU(group C,n=722).The main outcome was the proportion of mature oocytes retrieved,fertilization rates,clinical pregnancy rates,cumulative pregnancy rates and incidence of ovarian hyperstimulation syndrome(OHSS).Results No evidence of statistically difference was found in the proportion of mature oocytes retrieved(89.92%,91.40%,90.20%,respectively) and fertilization rate(79.8%,80.07%,80.51%,respectively)among groups A,B and C.Serum E2level on the day of hCG injection,the number of mature oocytes retrieved and good-quality embryos in group A were significantly higher than those in group B and group C.Clinical pregnancy rates per transfer cycle(45.95%,43.97%and 44.25%),ongoing pregnancy rates(43.17%,40.91%and 42.53%),implantation rates(30.74%,27.78%and 29.86%) and cumulative pregnancy rates per patient(58.31%,53.6%and 54.85%) were comparable among groups A,B and C.The incidence of OHSS in groups A,B and C(0%,0.14%and 0.28%) was low,with no significant difference.Conclusion A reduced hCG dose of 2 000 IU for moderate or high responders leads to similar efficacy compared with a dose of 5 000 IU in inducing oocyte maturation without adversely affecting the pregnancy outcome meanwhile eliminating the risk of OHSS.
