Faculty of Health Sciences, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Fertility Clinic, Unit of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark; Research Unit of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark.
Faculty of Health Sciences, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN, Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark.
Reprod Biomed Online. 2022 Oct;45(4):793-804. doi: 10.1016/j.rbmo.2022.04.019. Epub 2022 May 6.
Is there an association between the ovulation trigger dose of human chorionic gonadotrophin (HCG) and endogenous progesterone production during the luteal phase?
This randomized controlled four-arm study, at the Fertility Clinic, Odense University Hospital, Denmark, included women undergoing gonadotrophin-releasing hormone (GnRH) antagonist IVF treatment with ≤11 follicles ≥12 mm. Group 1-3 were triggered with 5000 IU, 6500 IU or 10,000 IU HCG, respectively, receiving 17α-hydroxyprogesterone caproate intramuscularly for luteal-phase support (LPS) to measure endogenous progesterone production. Group 4 received 6500 IU HCG trigger and vaginal progesterone. During the study, the 5000 IU and 10,000 IU HCG groups were switched from urinary to recombinant HCG, as urinary HCG was removed from market. Eight blood samples were drawn during the luteal phase.
Ninety-four participants completed the study. There was a significant positive association between the HCG trigger dose and the progesterone at 8 days (P < 0.001), 10 days (P < 0.001) and 14 days (P < 0.001) post-oocyte retrieval. Comparing the groups individually revealed a significant difference in progesterone concentration between low and high trigger doses at 4 days (P = 0.037) and 8 days (P = 0.007) post-oocyte retrieval and between all intervention groups at oocyte retrieval + 6 days: group 1 and 2 (P = 0.011), group 2 and 3 (P = 0.042) and group 1 and 3 (P < 0.001). Higher HCG trigger dose increased the progesterone from the individual follicle.
Increasing HCG trigger doses significantly increased endogenous progesterone concentration during the mid-late luteal phase.
人绒毛膜促性腺激素（HCG）的排卵触发剂量与黄体期内源性孕激素产生之间是否存在关联？
这项在丹麦奥胡斯大学医院生育诊所进行的随机对照四臂研究纳入了接受 GnRH 拮抗剂 IVF 治疗且卵泡数≤11 个、卵泡大小≥12mm 的女性。第 1-3 组分别接受 5000IU、6500IU 或 10000IU 的 HCG 触发排卵，接受肌肉注射 17α-羟孕酮己酸进行黄体期支持（LPS）以测量内源性孕激素产生。第 4 组接受 6500IU 的 HCG 触发排卵和阴道用孕激素。在研究过程中，由于尿源性 HCG 已从市场上撤出，5000IU 和 10000IU 的 HCG 组转为使用重组 HCG。在黄体期共抽取 8 份血样。
94 名参与者完成了研究。HCG 触发剂量与取卵后 8 天（P < 0.001）、10 天（P < 0.001）和 14 天（P < 0.001）的孕激素水平呈显著正相关。单独比较各组发现，取卵后 4 天（P=0.037）和 8 天（P=0.007）低和高触发剂量之间的孕激素浓度存在显著差异，并且在取卵日+6 天所有干预组之间也存在显著差异：第 1 组和第 2 组（P=0.011）、第 2 组和第 3 组（P=0.042）以及第 1 组和第 3 组（P<0.001）。较高的 HCG 触发剂量增加了单个卵泡的孕激素。
增加 HCG 触发剂量显著增加了黄体中期晚期的内源性孕激素浓度。
