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Korean Journal of Obstetrics & Gynecology 2007;50(4):645-652.
Published online April 1, 2007.
Clinical trial comparing recombinant human chorionic gonadotropin (hCG) to urinary hCG for induction of final follicular maturation in IVF-ET.
Hyang Ah Lee, Chung Hoon Kim, Yun Hee Koo, Mi Won Seo, Sung Hoon Kim, Hee Dong Chae, Byung Moon Kang
1Department of Obstetrics and Gynecology, Kang Won national university, Colledge of medicine, Chun cheon Korea.
2Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea. chnkim@amc.seoul.kr
Abstract
OBJECT: Human chorionic gonadotropin (hCG) is used to induce final follicular maturation in women undergoing controlled ovarian hyperstimulation (COH). Urinary preparations are associated with a number of disadvantages including an uncontrolled source, batch-to-batch variability and lack of purity. We performed this study to compare the efficacy of recombinant hCG and urinary hCG for induction of final follicular maturation in women undergoing IVF-ET. METHODS: Prospective trial was performed on a total of 84 IVF cycles carried out in 84 infertile women with tubal and peritoneal factor. Patients were randomized 1:1 to 250 microgram of recombinant hCG subcutaneous injection or 10,000 IU of urinary hCG intramuscular injection after completing recombinant human follicle stimulating hormone (FSH) stimulation. Oocyte pickup was scheduled 36 hours after hCG administration and embryos were transferred 3 days after oocyte pickup. We measured the efficacy points including the number of retrieved and fertilized oocytes, quality of oocytes and embryos, and clinical pregnancy rate. RESULTS: Serum progesterone and hCG level on post-hCG day 5 were significantly higher in the recombinant hCG group (p<0.01, p<0.05). There were no significant differences in outcome including the number of retrieved oocytes, quality of oocytes and embryos, clinical pregnancy rate between the two preparations. The incidence of injection-site reactions such as pain, itching, and bruising were significantly lower in the recombinant hCG group (p<0.01, p<0.01 and p<0.05). CONCLUSIONS: For triggering ovulation, recombinant hCG seems to have significant advantages compared with urinary hCG in terms of luteal progesterone and local tolerance.
Key Words: Recombinant human chorionic gonadotropin (r-hCG), Urinary human chorionic gonadotropin (u-hCG), In vitro fertilization and embrio-transter (IVF-ET)
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