Clinical trial comparing recombinant human chorionic gonadotropin (hCG) to urinary hCG for induction of final follicular maturation in IVF-ET / 대한산부인과학회지

OBJECT: Human chorionic gonadotropin (hCG) is used to induce final follicular maturation in women undergoing controlled ovarian hyperstimulation (COH). Urinary preparations are associated with a number of disadvantages including an uncontrolled source, batch-to-batch variability and lack of purity. We performed this study to compare the efficacy of recombinant hCG and urinary hCG for induction of final follicular maturation in women undergoing IVF-ET. METHODS: Prospective trial was performed on a total of 84 IVF cycles carried out in 84 infertile women with tubal and peritoneal factor. Patients were randomized 1:1 to 250 microgram of recombinant hCG subcutaneous injection or 10,000 IU of urinary hCG intramuscular injection after completing recombinant human follicle stimulating hormone (FSH) stimulation. Oocyte pickup was scheduled 36 hours after hCG administration and embryos were transferred 3 days after oocyte pickup. We measured the efficacy points including the number of retrieved and fertilized oocytes, quality of oocytes and embryos, and clinical pregnancy rate. RESULTS: Serum progesterone and hCG level on post-hCG day 5 were significantly higher in the recombinant hCG group (p<0.01, p<0.05). There were no significant differences in outcome including the number of retrieved oocytes, quality of oocytes and embryos, clinical pregnancy rate between the two preparations. The incidence of injection-site reactions such as pain, itching, and bruising were significantly lower in the recombinant hCG group (p<0.01, p<0.01 and p<0.05). CONCLUSIONS: For triggering ovulation, recombinant hCG seems to have significant advantages compared with urinary hCG in terms of luteal progesterone and local tolerance.

A Case of Empty Follicle Syndrome with Successful Oocyte Retrieval by Use of Recombinant Human Chorionic Gonadotropin / 대한산부인과학회지

It has been decades since the concept of empty follicle syndrome (EFS), in which no oocytes are retrieved in an in vitro fertilization and embryo transfer (IVF-ET) cycle, was introduced. The incidence of this syndrome in patients undergoing IVF-ET has been estimated to be about 0.6-7%. The use of recombinant human chorionic gonadotropin (r-hCG) can be a useful option for the EFS patients with previous failure of oocyte retrieval in IVF-ET cycles. We present a case of empty follicle syndrome with successful oocyte retrieval by the use of r-hCG.