Pregnancy rate and ovarian hyperstimulation after luteal human chorionic gonadotropin in in vitro fertilization stimulated with gonadotropin-releasing hormone analog and menotropins

Fertil Steril. 1990 Jan;53(1):92-6. doi: 10.1016/s0015-0282(16)53222-1.

Abstract

The value of luteal phase supplementation with human chorionic gonadotropin (hCG) was assessed after a combined protocol of ovarian stimulation, using a long acting gonadotropin releasing hormone analog (GnRH-a) and human menopausal gonadotropins (hMG), in a randomized prospective study of 36 consecutive cycles in an in vitro fertilization (IVF) program. The patients were allocated on the transfer day to either luteal phase supplementation with hCG (Group A, n = 18) or none (Group B, n = 18). Nine patients of Group A conceived as compared with 3 in Group B. Five patients, all in Group A, developed ovarian hyperstimulation syndrome (OHSS) (3 moderate and 2 severe forms). Analysis of the hormonal profiles disclosed similar progesterone (P), estradiol (E2), and E2/P ratio up to the 6th post ovum pick-up day. Then, E2 and mainly P levels decreased only in Group B resulting in a rising E2/P ratio. These findings stress the importance of luteal support in IVF cycles treated with GnRH-a. In light of the increased risk of OHSS among hCG treated patients, further studies are needed to assess the optimal preparation needed.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Chorionic Gonadotropin / pharmacology*
  • Embryo Transfer
  • Estradiol / blood
  • Female
  • Fertilization in Vitro / drug effects*
  • Gonadotropin-Releasing Hormone / adverse effects
  • Gonadotropin-Releasing Hormone / analogs & derivatives*
  • Gonadotropin-Releasing Hormone / pharmacology
  • Humans
  • Menotropins / pharmacology*
  • Menstruation / drug effects
  • Ovarian Diseases / chemically induced
  • Ovarian Diseases / physiopathology
  • Ovary / drug effects*
  • Ovary / physiology
  • Pregnancy / drug effects*
  • Pregnancy / physiology
  • Progesterone / blood
  • Prospective Studies
  • Syndrome
  • Triptorelin Pamoate / adverse effects
  • Triptorelin Pamoate / pharmacology*

Substances

  • Chorionic Gonadotropin
  • Triptorelin Pamoate
  • Gonadotropin-Releasing Hormone
  • Progesterone
  • Estradiol
  • Menotropins