Low plasma levels of hCG after 10,000-IU hCG injection do not reduce the number or maturation of oocytes recovered in patients undergoing assisted reproduction (original) (raw)
Related papers
Fertility and Sterility, 2006
Objective: To find whether the percentage of mature oocytes can be increased in the following ICSI cycle, in a selected group of patients with Ն47% immature oocytes, with the prolongation of hCG-to-oocyte retrieval interval. Design: Randomized study. Setting: In vitro fertilization unit in a medical center in Israel. Patient(s): From January 2003 to June 2005, in 72 of 2,650 intracytoplasmic sperm injection cycles (2.8%), Ն47% of the total aspirated oocytes were immature (group A). In the following treatment cycle, with similar controlled ovarian hyperstimulation, hCG was planned to be injected in the same interval (group B) as well as 3-4 hours earlier (group C). In fact, the hCG-to-oocyte retrieval interval in group C was statistically significantly longer (38.6 Ϯ 1.2 hours) compared with that in group B (35.3 Ϯ 0.7 hours).
Oocyte recovery and fertilization rates in women at various times after the administration of hCG
Reproduction, 1986
Volunteer women requesting laparoscopic sterilization were subjected to a fixed schedule of ovulation induction and oocyte recovery. Follicle aspiration was carried out in four groups: those to whom hCG was not administered and 12, 24 or 36 h respectively after the administration of hCG. For each group oocytes were cultured in vitro for 42 h, 30 h, 18 h and 6 h respectively, before insemination with donor spermatozoa. Oocyte recovery rates improved with longer hCG-to-recovery intervals (36% with no hCG to 81% 36 h after hCG). Although there was a slight reduction in fertilization rates when oocytes were not exposed to hCG in the follicle, normal cleavage was noted in more than 50% of oocytes in all four groups. It therefore appears that the final maturation stages of the human oocyte are not dependent on the midcycle gonadotrophin surge, provided the oocyte is matured in vitro before insemination.
Human Reproduction, 2003
BACKGROUND: Fertilization treatment using oocytes matured in vitro from pre-ovulatory follicles has many potential applications. It minimizes the risk of severe ovarian hyperstimulation and is an alternative for women with polycystic ovary syndrome who may have problems regarding stimulation for IVF. In-vitro maturation (IVM) may prove important for subjects needing fertility preservation, and also provides information about the ®nal stages of oocyte maturation. METHODS: From a randomized study of 73 women in an IVF programme, 36 subjects with 228 oocytes were allocated for oocyte maturation in culture medium with recombinant hCG, and 37 subjects with 256 oocytes for maturation with recombinant LH. The primary outcome was the rate of nuclear maturation of oocytes to metaphase II. During the same period, 32 women outside the study underwent 38 individually tailored IVM treatments. RESULTS: The oocyte maturation rate was 54.8% with hCG and 55.9% with LH; fertilization and cleavage rates were not signi®cantly different. Three pregnancies were achieved in the hCG group and one in the LH group. Seven pregnancies (22.6% per embryo transfer) were achieved in the parallel group. CONCLUSIONS: Recombinant hCG or LH are equally effective in promoting oocyte maturation in a clinical IVM programme.
The Journal of Clinical Endocrinology & Metabolism, 2005
Context: Different doses of human chorionic gonadotropin (hCG) have been used in various in vitro fertilization (IVF) treatment protocols to achieve final oocyte maturation. There is as yet no agreement on the optimum dose required. Objectives: The objective of this study was to compare the effectiveness of 250 and 500 g recombinant hCG (r-hCG), which represented the lower and upper limits of the dose range, in inducing final oocyte maturation during IVF and intracytoplasmic sperm injection cycles. Design: This was a prospective, randomized, double-blind study. Setting: This study was performed at an IVF clinic in a teaching hospital. Patients: Sixty patients with an indication for intracytoplasmic sperm injection were studied. Intervention: The treatment dose used was 250 or 500 g r-hCG. Main Outcome Measures: The percentage of metaphase II oocytes retrieved per patient, as an indicator of oocyte maturation, and the hormone profiles of the treatment cycle starting from the day of hCG up to hCGϩ10 d were the main outcome measures. Results: The percentage of metaphase II oocytes was similar in the two groups (89.3% vs. 86.0%; P ϭ 0.326) despite higher serum and follicular fluid hCG levels on hCGϩ2 and hCGϩ4 d, as was the follicular fluid to serum hCG ratio in the 500-g r-hCG group. Serum estradiol and progesterone levels were comparable initially, but became significantly higher in the 500-g r-hCG group on hCGϩ10 d. Conclusion: The two doses of r-hCG were equally effective in inducing final oocyte maturation. It remains unclear whether the higher midluteal estradiol and progesterone levels in the 500-g r-hCG group confer any benefit.
Fertility and Sterility, 2003
To investigate the impact of delaying the transfer of in vitro fertilized embryos to day 5 on embryo development by comparing serum beta-hCG levels in pregnancies established after day 3 embryo transfers and those after day 5 blastocyst transfers at equivalent time intervals after fertilization. A retrospective analysis. Assisted reproductive technology center in an academic research environment. Women who had an embryo transfer procedure performed after in vitro fertilization (IVF) at Northwestern University's IVF Program between January 1999 and December 2001 were included in this study. Embryo transfer was performed either on day 3 or day 5 after oocyte retrieval for IVF (day 0), depending on the availability of good-quality embryos on day 3. Serum beta-hCG concentrations determined 13 and 15 days after fertilization in pregnancies established by transferring cleavage-stage embryos on day 3 or blastocysts on day 5. In singleton pregnancies, serum beta-hCG concentrations were 75 +/- 54 (mean +/- SD, n = 203) or 62 +/- 41 (n = 109) IU/mL after day 3 or day 5 transfers, respectively. In twin pregnancies, the beta-hCG concentrations were 162 +/- 105 (n = 52) or 109 +/- 55 (n = 49) after day 3 or day 5 transfers, respectively. The percentage increases in beta-hCG concentrations between the first and second measurements were similar in the two groups (day 3: 144 +/- 109, day 5: 142 +/- 63, not statistically significant). Initial beta-hCG concentrations in pregnancies resulting from day 5 transfers were lower than those from day 3 transfers when assessed at equivalent intervals from fertilization. This suggests that embryo development or implantation may be impaired by the additional 2 days in culture.
Fertility and Sterility, 2011
Objective: To compare b-hCG levels measured as the first pregnancy test in women who conceived after in vitro maturation (IVM) or IVF. Design: Retrospective matched cohort analysis. Setting: University-based medical center. Patient(s): Women treated with IVM or IVF. Intervention(s): We studied the first serum b-hCG levels in 104 pregnant women who were successfully treated with IVM and in another 104 women with IVF treatment. Blood samplings for b-hCG were drawn on day 12-15 after ET. The two groups were matched by age, order of pregnancy, and day of blood sampling. Main Outcome Measure(s): First b-hCG levels. Result(s): Serum b-hCG levels on days 12 to 13 after ET of IVM viable singleton pregnancies were significantly higher than those of IVF pregnancies (343.2 AE 48.4 vs. 264.0 AE 29.2 IU/L, 95% confidence interval [CI] 22-229). Similarly, b-hCG levels on days 14 to 15 after ET of IVM viable singleton pregnancies were higher than those of IVF pregnancies (350.1 AE 126.4 vs. 284.4 AE 30.2 IU/L). Similar trends were found in b-hCG levels on days 12 to 13 after ET of twin viable pregnancies (IVM, 682.1 AE 97.7 vs. IVF, 434.5 AE 41.8 IU/L; 95% CI 44-662). Grouped linear regression with covariance analysis showed a significant difference between IVM and IVF regression lines. Conclusion(s): The first serum b-hCG levels in pregnancies after IVM are consistently higher than those after IVF treatment. More studies are needed to elucidate these findings. (Fertil Steril Ò 2011;95:85-8.
Fertility and Sterility
Objective: To determine threshold b-hCG levels predictive of an ongoing pregnancy (OP), live birth (LB), and multiple gestation (MG) in IVF cycles resulting from day-3 (D3) vs. day-5 (D5) embryo transfers (ET), to compare IVF cycle characteristics and pregnancy outcomes in D3 vs. D5 ET groups, and to assess the degree to which maternal characteristics and cycle parameters were predictive of higher b-hCG levels. Design: Retrospective analysis. Setting: Infertility center. Patient(s): Women who had ET performed for IVF cycles between July 2004 and January 2010. Intervention(s): Embryo transfer performed on either D3 or D5 after oocyte fertilization. Main Outcome Measure(s): Beta-hCG on day 15 after oocyte fertilization. Result(s): Beta-hCG levels were significantly higher with D5 ET compared with D3 ETs (D3: 103.6 AE 4.4 IU/L vs. D5: 198.0 AE 10.6 IU/L), and a multivariate analysis demonstrated that D5 ET was a significant predictor of higher b-hCG levels. The b-hCG thresholds predictive of OP were 78 IU/L and 160 IU/L for D3 and D5 ET, which predicted OP in 96% and 91% of cases, respectively. Similarly, for LB, the b-hCG thresholds were 94 IU/L (79% positive predictive value [PPV]) and 160 IU/L (88% PPV), and for MG were 250 IU/L (18% PPV) and 316 IU/L (34% PPV), respectively. Conclusion(s): Initial b-hCG levels are dependent on the day of ET and are a reliable and highly predictive tool for OP outcomes. (Fertil Steril Ò 2011;96:1362-6.
Vol 17, No 4, October-December , 2023
Background: In vitro fertilization (IVF) remains a main treatment for infertility cases. Post-injection human chorionic gonadotropin (hCG) level is an essential factor in determining oocyte maturation rate in IVF. This study aimed to determine the relationship between 12 hours post-injection serum hCG level and oocyte maturation rate among IVF participants. Materials and Methods: A cross-sectional study on IVF participants was done at a tertiary hospital in Indonesia from January 2020 to December 2021. Subjects were injected with 250 µg of recombinant-hCG (r-hCG) subcutaneously. Twelve hours post-injection serum hCG levels and oocyte maturation rate data were retrieved and analyzed accordingly. Results: Twenty-eight subjects were recruited into the study. Higher 12 hours post-injection serum hCG was related to oocyte maturation rate (P=0.046). The cutoff point of 12 hours post-injection serum hCG to predict better oocyte maturation rate was 90.15 mIU/mL (sensitivity 68.2%, specificity 83.3%). Oocyte maturation rate may be predicted using body mass index (BMI) and 12 hours post-injection serum hCG. Conclusion: Higher 12 hours post-injection serum hCG was associated with a higher oocyte maturation rate in IVF subjects.
The impact of different time intervals between hCG priming and oocyte retrieval on ART outcomes
Iranian journal of reproductive medicine, 2013
Abnormal oocyte morphology has been associated with the hormonal environment to which the gametes are exposed. In this study, we evaluated the oocytes morphology, fertilization rate, embryos quality, and implantation rate resulted of retrieved oocytes in different times after human chorionic gonadotrophin (HCG) administration. A total of 985 metaphase II oocytes were retrieved 35, 36, 37 and 38 h after the injection of HCG as groups 1, 2, 3, and 4 respectively. Oocyte morphology was divided into (I) normal morphology, (II) extracytoplasmic abnormalities, (III) cytoplasmic abnormalities and (IV) intracytoplasmic vacuoles and in each group, oocytes were evaluated according to this classification. Extracytoplasmic abnormalities were encountered in 17.76% and 31.1% of these oocytes (groups 3 and 4 respectively, p=0.007) in comparison with 12.23% group 2. Cytoplasmic abnormalities in group 4 were higher than other groups. 23.88% (p=0.039) and 43.25% (p=0.089) of resulted 2PN (two pronucl...