Department of Gynecology & Obstetrics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.
Eur J Obstet Gynecol Reprod Biol. 2011 Nov;159(1):143-7. doi: 10.1016/j.ejogrb.2011.07.009. Epub 2011 Aug 6.
To compare the effectiveness of urinary human chorionic gonadotropin (u-hCG) at reduced doses of 4000 IU and 6000 IU in inducing final oocyte maturation during in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles.
164 patients with an indication for IVF or ICSI recruited in this randomized, single-blinded and controlled study in IVF clinic at the Sun Yat-sen Memorial Hospital. Patients were prospectively randomized to receive 4000 IU (Group A, n=83) and 6000 IU (Group B, n=81) of hCG for triggering final oocyte maturation. Number or percentage of mature oocytes retrieved per patient, fertilization rates, pregnancy rates were the main outcome measures.
No evidence of statistically significant difference in the number or proportion of mature oocytes retrieved was observed in both groups. The lower fertilization rate and significantly lower clinical pregnancy rate were observed in Group A. The ovarian hyperstimulation syndrome (OHSS) rates in both groups were also similar. In the subgroup of BMI< 20 kg/m(2), fertilization rate were significantly higher in the administration group of hCG at the dose of 6000 IU when compared with the dose of 4000 IU (82.40% vs. 70.92%, P=0.017); in contrast, no significant difference in clinical pregnancy rates was observed in both groups. In the subgroup of BMI 20-25 kg/m(2), clinical pregnancy rates were significantly higher in patients treated with hCG at dose of 6000 IU than patients treated with hCG at dose of 4000 IU (65.3% vs. 35.0%, P=0.004); however, no significant difference in fertilization rates was observed.
Both doses of u-hCG revealed an equal effect on the induction of final oocyte maturation in the patients with moderate or high ovarian response; however, the reduced dose of hCG could result in an obvious impact on clinical pregnancy rates and did not exhibit an obvious effect on OHSS rates.
比较人绒毛膜促性腺激素（hCG）在 4000IU 和 6000IU 两种不同剂量下用于体外受精（IVF）和卵胞浆内单精子注射（ICSI）周期中诱导卵母细胞最终成熟的效果。
本研究为随机、单盲、对照临床试验，纳入在中山大学附属第二医院 IVF 门诊就诊的 164 名 IVF 或 ICSI 适应证患者。患者前瞻性随机分为 4000IU（A 组，n=83）和 6000IU（B 组，n=81）hCG 组，以触发卵母细胞最终成熟。主要观察指标为每位患者获得的成熟卵母细胞数或百分比、受精率和妊娠率。
两组间获得的成熟卵母细胞数或比例均无统计学差异。A 组的受精率较低，临床妊娠率明显较低。两组卵巢过度刺激综合征（OHSS）发生率也相似。在 BMI<20kg/m2 的亚组中，与 4000IU 剂量组相比，6000IU 剂量组的受精率显著更高（82.40%比 70.92%，P=0.017）；而两组的临床妊娠率无显著差异。在 BMI 20-25kg/m2 的亚组中，6000IU 剂量组的临床妊娠率明显高于 4000IU 剂量组（65.3%比 35.0%，P=0.004）；然而，两组的受精率无显著差异。
两种剂量的 u-hCG 对中、高卵巢反应患者的卵母细胞最终成熟诱导效果相同；但 hCG 低剂量可明显影响临床妊娠率，对 OHSS 发生率无明显影响。
