Iaconelli Carla Andrade Rebello, Setti Amanda Souza, Braga Daniela Paes Almeida Ferreira, Maldonado Luiz Guilherme Louzada, Iaconelli Assumpto, Borges Edson, Aoki Tsutomu
a Fertility Medical Group, clinical department ; Sao Paulo , SP , Brazil.
b Faculdade de Ciências Médicas da Santa Casa de São Paulo, health sciences department ; Sao Paulo , SP , Brazil.
Hum Fertil (Camb). 2017 Dec;20(4):285-292. doi: 10.1080/14647273.2017.1303197. Epub 2017 Mar 22.
The objective of this study was to investigate the effects of low-dose hCG supplementation on ICSI outcomes and controlled ovarian stimulation (COS) cost. Three hundred and thirty patients undergoing ICSI were split into groups according to the COS protocol: (i) control group (n = 178), including patients undergoing conventional COS treatment; and (ii) low-dose hCG group (n = 152), including patients undergoing COS with low-dose hCG supplementation. Lower mean total doses of FSH administered and higher mean oestradiol level and mature oocyte rates were observed in the low-dose hCG group. A significantly higher fertilization rate, high-quality embryo rate and blastocyst formation rate were observed in the low-dose hCG group as compared to the control group. The miscarriage rate was significantly higher in the control group compared to the low-dose hCG group. A significantly lower incidence of OHSS was observed in the low-dose hCG group. There was also a significantly lower gonadotropin cost in the low-dose hCG group as compared to the control group ($1235.0 ± 239.0×$1763.0 ± 405.3, p < 0.001). The concomitant use of low-dose hCG and FSH results in a lower abortion rate and increased number of mature oocytes retrieved, as well as improved oocyte quality, embryo quality and blastocyst formation and reduced FSH requirements.
本研究的目的是探讨低剂量人绒毛膜促性腺激素(hCG)补充对卵胞浆内单精子注射(ICSI)结局及控制性卵巢刺激(COS)成本的影响。330例接受ICSI的患者根据COS方案分为两组:(i)对照组(n = 178),包括接受传统COS治疗的患者;(ii)低剂量hCG组(n = 152),包括接受低剂量hCG补充的COS患者。低剂量hCG组观察到促卵泡生成素(FSH)平均总给药剂量较低,平均雌二醇水平和成熟卵母细胞率较高。与对照组相比,低剂量hCG组的受精率、优质胚胎率和囊胚形成率显著更高。对照组的流产率显著高于低剂量hCG组。低剂量hCG组卵巢过度刺激综合征(OHSS)的发生率显著更低。与对照组相比,低剂量hCG组的促性腺激素成本也显著更低(1235.0±239.0美元对1763.0±405.3美元,p<0.001)。低剂量hCG与FSH联合使用可降低流产率,增加回收的成熟卵母细胞数量,提高卵母细胞质量、胚胎质量和囊胚形成,并减少对FSH的需求。