Dynamics of the development of multiple follicles by early versus late hCG administration in ART program

Abstract

Objective: To evaluate, in patients stimulated with recombinant FSH and GnRH antagonists, whether triggering the final maturation of oocytes affects IVF outcomes.

Study design: Five hundred and six IVF procedures were divided into three groups according to the timing of hCG administration: when at least 2 follicles reached the diameter of 17 mm, at least 2 follicles reached 18 mm and at least 2 follicles reached 20 mm. The main outcome was the number of mature oocyte that was the dependent variable of a multivariate model whose independents were, age, AFC, hCG timing, E2 levels at hCG day, number of follicles in different categories of dimension. Secondary endpoints were to compare fertilization, implantation and pregnancy rates in a multilevel multivariate model whose covariates were age, BMI, AFC, embryo quality and cause of infertility.

Results: Timing did not result a statistically significant factor influencing the number of oocytes collected, which was influenced by age, AFC, number of follicles between 12.1 and 15.9 mm and E2 levels. Implantation rate and pregnancy rate appear to be affected only by embryo quality.

Conclusion: The number of oocytes collected and the probability of pregnancy are not associated with the time of hCG administration.

Chinese abstract

目的: 评估在使用重组FSH和GnRH拮抗剂刺激患者体内, 这些药物是否能触发卵母细胞的最终成熟从而影响IVF结果。

研究设计: 根据hCG给药的时间将506个IVF治疗周期分为三组: 至少2个卵泡分别达到直径17mm、18mm及20mm。 主要观察指标是作为多变量模型因变量的成熟卵母细胞的数量, 其独立因素为年龄, AFC, hCG给药时机, hCG治疗日的E2水平, 不同阶段的卵泡数量。次要终点是比较在多变量多变量模型中的受精、植入和妊娠率, 其协变量是年龄, BMI, AFC, 胚胎质量和不孕原因。

结果: hCG给药时间对卵母细胞数量的影响无显著统计学意义, 其受年龄, AFC, 直径在12.1和15.9mm之间卵泡数量和E2水平的影响。植入率和妊娠率似乎只受胚胎质量的影响。

结论: 采集的卵母细胞数和妊娠的概率与hCG给药的时间无关。

Keywords:

• hCG administration
• hCG timing
• mature oocytes
• pick up timing

Declaration of interest

The authors report no conflicts of interest.