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This version published online on May 3, 2005
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2004-2169
A more recent version of this article appeared on July 1, 2005
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Submitted on November 3, 2004
Accepted on April 18, 2005

A prospective randomized double-blind study to compare two doses of recombinant human chorionic gonadotrophin in inducing final oocyte maturity and the hormonal profile during the luteal phase

Carina CW Chan*, Ernest HY Ng, OS Tang, William SB Yeung, Estella YL Lau, and PC Ho

Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong

* To whom correspondence should be addressed. E-mail: cwcchan{at}graduate.hku.hk.

Context: Different doses of human chorionic gonadotrophin (hCG) have been used in various IVF treatment protocols to achieve final oocyte maturation. There is as yet an agreement on the optimum dose required.

Objectives: To compare the effectiveness of 250 µg and 500 µg recombinant-hCG (r-hCG), which represented the lower and upper limits of the dose range, in inducing final oocyte maturation during IVF and ICSI cycles.

Design: Prospective randomized double-blind study.

Setting: IVF clinic in a teaching hospital.

Patients: Sixty patients with an indication for ICSI.

Intervention: 250 µg or 500 µg r-hCG.

Main outcome measures: The percentage of metaphase II (MII) oocytes retrieved per patient as an indicator of oocyte maturation and the hormone profiles of the treatment cycle starting from the day of hCG up to hCG+10 days.

Results: The percentage of MII oocytes was similar between the two groups (89.3% versus 86.0%, p=0.326) despite higher serum and follicular fluid hCG levels on hCG+2 and hCG+4 days as well as the follicular fluid to serum hCG ratio in the 500 µg r-hCG group. The serum estradiol and progesterone levels were comparable initially but became significantly higher in the 500 µg r-hCG group on hCG+10 day.

Conclusion: The two doses of r-hCG were equally effective in inducing final oocyte maturation. It remains unclear whether the higher mid-luteal estradiol and progesterone levels in the 500 µg r-hCG group confer any benefit.
Key words: hormone profiles • metaphase II oocytes • oocyte maturation • recombinant human chorionic gonadotrophin




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