Investigation of luteal HCG supplementation in GnRH-agonist-triggered fresh embryo transfer cycles: a randomized controlled trial
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Does splitting the human chorionic gonadotrophin (HCG) support in IVF cycles triggered by a gonadotrophin-releasing hormone agonist result in a better progesterone profile?
Design
Randomized controlled three-arm study, performed at the Fertility Clinic, Odense University Hospital, Denmark. Patients with 12–25 follicles ≥12 mm were randomized into three groups: Group 1 – ovulation triggered with 6500 IU HCG; Group 2 – ovulation triggered with 0.5 mg GnRH agonist, followed by 1500 IU HCG on the day of oocyte retrieval (OCR); and Group 3 – ovulation triggered with 0.5 mg GnRH agonist, followed by 1000 IU HCG on the day of OCR and 500 IU HCG on OCR + 5. All groups received 180 mg vaginal progesterone. Progesterone concentrations were analysed in eight blood samples from each patient.
Results
Sixty-nine patients completed the study. Baseline and laboratory data were comparable. Progesterone concentration peaked on OCR + 4 in Groups 1 and 2, and peaked on OCR + 6 in Group 3. On OCR + 6, the progesterone concentration in Group 2 was significantly lower compared with Groups 1 and 3 (P = 0.003 and P < 0.001, respectively). On OCR + 8, the progesterone concentration in Group 3 was significantly higher compared with the other groups (both P<0.001). Progesterone concentrations were significantly higher in Group 3 from OCR + 6 until OCR + 14 compared with the other groups (all P ≤ 0.003). Four patients developed ovarian hyperstimulation syndrome in Group 3.
Conclusion
Sequential HCG support after a GnRH agonist trigger provides a better progesterone concentration in the luteal phase.
| Originalsprog | Engelsk |
|---|---|
| Artikelnummer | 103415 |
| Tidsskrift | Reproductive BioMedicine Online |
| Vol/bind | 48 |
| Udgave nummer | 5 |
| Antal sider | 12 |
| ISSN | 1472-6483 |
| DOI | |
| Status | Udgivet - 2024 |
Bibliografisk note
Funding Information:
An unrestricted grant was received from NordicInfu Care, Sweden . Grants were also received from the University of Southern Denmark , Region of Southern Denmark , OPEN, and The Research Fund of Chief Doctor Committee OUH . The funding providers were not involved in the study, the writing process or approval of the manuscript.
Funding Information:
The authors wish to thank all patients who participated in this trial. Secondly, the authors wish to thank the doctors, nurses and laboratory staff from the Fertility Clinic, Odense University Hospital for their active participation in the study. Finally, the authors wish to thank the Department for Clinical Biochemistry and Pharmacology and OPEN at Odense University Hospital for assistance in biobanking and serum analyses. LS, PH, KE, and CYA designed the study. DEP and LS recruited the majority of the patients. LS drafted the manuscript, and PH, JF, CYA, KE, DEP and SM contributed to the interpretation of data and critically reviewed the manuscript. SM and LS performed the statistical analyses. All authors accepted the final draft. EudraCT 2013-003304-39. An unrestricted grant was received from NordicInfu Care, Sweden. Grants were also received from the University of Southern Denmark, Region of Southern Denmark, OPEN, and The Research Fund of Chief Doctor Committee OUH. The funding providers were not involved in the study, the writing process or approval of the manuscript.
Publisher Copyright:
© 2023
ID: 385686169