R Hoyos Luis, Khan Sana, Dai Jing, Singh Manvinder, P Diamond Michael, E Puscheck Elizabeth, O Awonuga Awoniyi
1. Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit Medical Center, Detroit, MI, USA.
2. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit Medical Center, Detroit, MI, USA.
Int J Fertil Steril. 2017 Apr-Jun;11(1):7-14. doi: 10.22074/ijfs.2016.5145. Epub 2016 Nov 11.
Currently, there is no agreement on the optimal urinary derived human chorionic gonadotropin (u-hCG) dose requirement for initiating final oocyte maturation prior to oocyte collection in fertilization (IVF), but doses that range from 2500- 15000 IU have been used. We intended to determine whether low dose u-hCG was effective for oocyte maturation in IVF/intracytoplasmic sperm injection (ICSI) cycles independent of body mass index (BMI).
We retrospectively evaluated a cohort of 295 women who underwent their first IVF/ICSI cycles between January 2003 and December 2010 at the Division of Reproductive Endocrinology and Infertility, Wayne State University, Detroit, MI, USA. Treatment cycles were divided into 3 groups based on BMI (kg/ m): <25 (n=136), 25- <30 (n=84), and ≥30 (n=75) women. Patients received 5000, 10000 or 15000 IU u-hCG for final maturation prior to oocyte collection. The primary outcome was clinical pregnancy rates (CPRs) and secondary outcome was live birth rates (LBRs).
Only maternal age negatively impacted (P<0.001) CPR [odds ratio (OR=0.85, confidence interval (CI: 0.79-0.91)] and LBR (OR=0.84, CI: 0.78-0.90).
Administration of lower dose u-hCG was effective for oocyte maturation in IVF and did not affect the CPRs and LBRs irrespective of BMI. Women's BMI need not be taken into consideration in choosing the appropriate dose of u-hCG for final oocyte maturation prior to oocyte collection in IVF. Only maternal age at the time of IVF negatively influenced CPRs and LBRs in this study.
目前，在体外受精（IVF）中卵母细胞采集前启动最终卵母细胞成熟所需的最佳尿源性人绒毛膜促性腺激素（u-hCG）剂量尚无定论，但已使用2500 - 15000国际单位的剂量。我们旨在确定低剂量u-hCG在IVF/卵胞浆内单精子注射（ICSI）周期中对卵母细胞成熟是否有效，且不受体重指数（BMI）影响。
我们回顾性评估了295名女性，她们于2003年1月至2010年12月在美国密歇根州底特律市韦恩州立大学生殖内分泌与不孕科接受了首次IVF/ICSI周期治疗。根据BMI（kg/m）将治疗周期分为3组：BMI<25（n = 136）、25≤BMI<30（n = 84）和BMI≥30（n = 75）的女性。患者在卵母细胞采集前接受5000、10000或15000国际单位的u-hCG用于最终成熟。主要结局是临床妊娠率（CPR），次要结局是活产率（LBR）。
仅产妇年龄对CPR（比值比（OR）= 0.85，置信区间（CI：0.79 - 0.91））和LBR（OR = 0.84，CI：0.78 - 0.90）有负面影响（P<0.001）。
在IVF中，给予较低剂量的u-hCG对卵母细胞成熟有效，且无论BMI如何，均不影响CPR和LBR。在IVF中选择合适的u-hCG剂量用于卵母细胞采集前的最终卵母细胞成熟时，无需考虑女性的BMI。在本研究中，仅IVF时的产妇年龄对CPR和LBR有负面影响。
