Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P.O Box:19395-4644, Tehran, Iran.
J Assist Reprod Genet. 2012 Nov;29(11):1213-20. doi: 10.1007/s10815-012-9854-3. Epub 2012 Sep 7.
To investigate the effect of late follicular administration of low dose hCG on oocyte maturity in poor responding women undergoing intracytoplasmic sperm injection (ICSI).
This prospective randomized pilot trial was performed on 73 poor responders undergoing ICSI, in Reproductive Biomedicine Research Center, Royan Institute, Tehran, Iran. All eligible patients underwent a GnRH-a long protocol and were randomly allocated into three study groups for ovarian stimulation: groupA received recombinant FSH alone, group B received recombinant FSH supplemented by 100 IU hCG. Group C received recombinant FSH supplemented by 200 IU hCG. The main endpoint was the number of metaphase II oocytes retrieved.
Of 78 poor responding patients entered to this study, 73 women were considered eligible for enrolment. Of these, 26 women were allocated to receive only recombinant FSH, 24 patients allocated to receive recombinant FSH and 100 IU hCG and 23 patients were assigned to receive recombinant FSH and 200 IU hCG. Number of oocytes retrieved were significantly higher in group B compared to group A (6.5 ± 3.3 versus 4.0 ± 2.3; P = .03). Other cycle and clinical outcomes were comparable between three groups.
The present study demonstrated that adding 100 IU hCG to rFSH in a GnRH agonist cycle in poor responders improve response to stimulation whereas the number of metaphase II oocytes remains comparable between groups. The existence of a possible trend toward higher mature oocytes and lower total dosage rFSH in patients received 100 or 200 IU hCG is probably due to the small sample size that means further large clinical trials in a more homogenous population is required (clinical trial registration number; NCT01509833).
探讨在接受卵胞浆内单精子注射（ICSI）的卵巢反应不良患者中，卵泡晚期给予低剂量 hCG 对卵母细胞成熟的影响。
本前瞻性随机试验在伊朗德黑兰 Royan 研究所生殖医学研究中心进行，纳入 73 名接受 ICSI 的卵巢反应不良患者。所有符合条件的患者均接受 GnRH-a 长方案，并随机分为三组进行卵巢刺激：A 组单独接受重组 FSH，B 组接受重组 FSH 加 100IU hCG，C 组接受重组 FSH 加 200IU hCG。主要终点为获得的 MII 卵母细胞数。
在纳入本研究的 78 名卵巢反应不良患者中，73 名女性符合入组条件。其中，26 名患者仅接受重组 FSH，24 名患者接受重组 FSH 和 100IU hCG，23 名患者接受重组 FSH 和 200IU hCG。B 组获得的卵母细胞数明显多于 A 组（6.5±3.3 与 4.0±2.3；P=0.03）。三组间其他周期和临床结局无差异。
本研究表明，在 GnRH 激动剂周期中，在重组 FSH 中添加 100IU hCG 可改善卵巢反应不良患者的反应，而各组间 MII 卵母细胞数无差异。接受 100 或 200IU hCG 的患者中，可能存在成熟卵母细胞数量增加和总剂量 rFSH 降低的趋势，但由于样本量小，需要进一步在更同质的人群中开展大型临床试验（临床试验注册号：NCT01509833）。
