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Erschienen in: Journal of Assisted Reproduction and Genetics 5/2018

23.03.2018 | Assisted Reproduction Technologies

Human chorionic gonadotropin serum levels following ovulation triggering and IVF cycle outcome

verfasst von: Yossi Mizrachi, Eran Horowitz, Jacob Farhi, David Levran, Arieh Raziel, Ariel Weissman

Erschienen in: Journal of Assisted Reproduction and Genetics | Ausgabe 5/2018

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Abstract

Purpose

The clinical significance of serum hCG levels after ovulation triggering was studied previously with conflicting results. Our aim was to study the correlation of hCG levels on the day after ovulation triggering using recombinant hCG (r-hCG) with treatment outcome.

Methods

A prospective observational study of all fresh IVF/ICSI cycles in a single medical center, between January 2015 and June 2016, was performed. hCG serum levels were obtained 10–12 h following ovulation triggering with 250 mcg r-hCG. Clinical and laboratory outcome parameters were compared between cycles with serum hCG above and below median level. A multivariate regression analysis was performed in order to study the association between hCG levels and live birth rate, after controlling for confounders.

Results

Overall, 326 cycles were included. Median serum hCG level was 91.35 IU/L. hCG levels were lower as age and BMI were higher (p = 0.004, p < 0.001, respectively). The study groups did not differ with regard to clinical pregnancy rate (p = 0.14), live birth rate (p = 0.09), fertilization rate (p = 0.45), or metaphase II oocyte rate (p = 0.68). On multivariate regression analysis, hCG level was not associated with live birth (aOR 0.99, 95% CI 0.98–1.005), after controlling for patient’s age and BMI.

Conclusions

hCG levels on the day after ovulation triggering with 250 mcg r-hCG are inversely correlated with patient age and BMI. However, they are not correlated with any clinical or laboratory outcome parameter. Therefore, testing for hCG levels after ovulation induction seems futile and cannot be recommended.
Literatur
1.
Zurück zum Zitat Gemzell C. Induction of ovulation with human gonadotropins. Recent Prog Horm Res. 1965;21:179–204.PubMed Gemzell C. Induction of ovulation with human gonadotropins. Recent Prog Horm Res. 1965;21:179–204.PubMed
4.
Zurück zum Zitat al-Hassan S, Fishel S, Fleming S, Thornton S. Low plasma levels of hCG after 10,000-IU hCG injection do not reduce the number or maturation of oocytes recovered in patients undergoing assisted reproduction. J Assist Reprod Genet. 1998;15(10):583–6.CrossRefPubMedPubMedCentral al-Hassan S, Fishel S, Fleming S, Thornton S. Low plasma levels of hCG after 10,000-IU hCG injection do not reduce the number or maturation of oocytes recovered in patients undergoing assisted reproduction. J Assist Reprod Genet. 1998;15(10):583–6.CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Wikland M, Borg J, Forsberg AS, Jakobsson AH, Svalander P, Waldenstrom U. Human chorionic gonadotrophin self-administered by the subcutaneous route to induce oocyte maturation in an in-vitro fertilization and embryo transfer programme. Hum Reprod. 1995;10(7):1667–70.CrossRefPubMed Wikland M, Borg J, Forsberg AS, Jakobsson AH, Svalander P, Waldenstrom U. Human chorionic gonadotrophin self-administered by the subcutaneous route to induce oocyte maturation in an in-vitro fertilization and embryo transfer programme. Hum Reprod. 1995;10(7):1667–70.CrossRefPubMed
8.
Zurück zum Zitat Weissman A, Lurie S, Zalel Y, Goldchmit R, Shoham Z. Human chorionic gonadotropin: pharmacokinetics of subcutaneous administration. Gynecol Endocrinol. 1996;10(4):273–6.CrossRefPubMed Weissman A, Lurie S, Zalel Y, Goldchmit R, Shoham Z. Human chorionic gonadotropin: pharmacokinetics of subcutaneous administration. Gynecol Endocrinol. 1996;10(4):273–6.CrossRefPubMed
9.
Zurück zum Zitat Chan CC, Ng EH, Chan MM, Tang OS, Lau EY, Yeung WS, et al. Bioavailability of hCG after intramuscular or subcutaneous injection in obese and non-obese women. Hum Reprod. 2003;18(11):2294–7.CrossRefPubMed Chan CC, Ng EH, Chan MM, Tang OS, Lau EY, Yeung WS, et al. Bioavailability of hCG after intramuscular or subcutaneous injection in obese and non-obese women. Hum Reprod. 2003;18(11):2294–7.CrossRefPubMed
10.
Zurück zum Zitat Salha O, Dada T, Sharma V. Influence of body mass index and self-administration of hCG on the outcome of IVF cycles: a prospective cohort study. Hum Fertil (Camb). 2001;4(1):37–42.CrossRef Salha O, Dada T, Sharma V. Influence of body mass index and self-administration of hCG on the outcome of IVF cycles: a prospective cohort study. Hum Fertil (Camb). 2001;4(1):37–42.CrossRef
12.
Zurück zum Zitat Elkind-Hirsch KE, Bello S, Esparcia L, Phillips K, Sheiko A, McNichol M. Serum human chorionic gonadotropin levels are correlated with body mass index rather than route of administration in women undergoing in vitro fertilization–embryo transfer using human menopausal gonadotropin and intracytoplasmic sperm injection. Fertil Steril. 2001;75(4):700–4.CrossRefPubMed Elkind-Hirsch KE, Bello S, Esparcia L, Phillips K, Sheiko A, McNichol M. Serum human chorionic gonadotropin levels are correlated with body mass index rather than route of administration in women undergoing in vitro fertilization–embryo transfer using human menopausal gonadotropin and intracytoplasmic sperm injection. Fertil Steril. 2001;75(4):700–4.CrossRefPubMed
13.
Zurück zum Zitat Carrell DT, Jones KP, Peterson CM, Aoki V, Emery BR, Campbell BR. Body mass index is inversely related to intrafollicular HCG concentrations, embryo quality and IVF outcome. Reprod BioMed Online. 2001;3(2):109–11.CrossRefPubMed Carrell DT, Jones KP, Peterson CM, Aoki V, Emery BR, Campbell BR. Body mass index is inversely related to intrafollicular HCG concentrations, embryo quality and IVF outcome. Reprod BioMed Online. 2001;3(2):109–11.CrossRefPubMed
14.
Zurück zum Zitat Weissman A, Farhi J, Royburt M, Nahum H, Glezerman M, Levran D. Prospective evaluation of two stimulation protocols for low responders who were undergoing in vitro fertilization-embryo transfer. Fertil Steril. 2003;79(4):886–92.CrossRefPubMed Weissman A, Farhi J, Royburt M, Nahum H, Glezerman M, Levran D. Prospective evaluation of two stimulation protocols for low responders who were undergoing in vitro fertilization-embryo transfer. Fertil Steril. 2003;79(4):886–92.CrossRefPubMed
16.
Zurück zum Zitat Abdalla HI, Ah-Moye M, Brinsden P, Howe DL, Okonofua F, Craft I. The effect of the dose of human chorionic gonadotropin and the type of gonadotropin stimulation on oocyte recovery rates in an in vitro fertilization program. Fertil Steril. 1987;48(6):958–63.CrossRefPubMed Abdalla HI, Ah-Moye M, Brinsden P, Howe DL, Okonofua F, Craft I. The effect of the dose of human chorionic gonadotropin and the type of gonadotropin stimulation on oocyte recovery rates in an in vitro fertilization program. Fertil Steril. 1987;48(6):958–63.CrossRefPubMed
17.
Zurück zum Zitat Chan CC, Ng EH, Tang OS, Yeung WS, Lau EY, Ho PC. A prospective, randomized, double-blind study to compare two doses of recombinant human chorionic gonadotropin in inducing final oocyte maturity and the hormonal profile during the luteal phase. J Clin Endocrinol Metab. 2005;90(7):3933–8. https://doi.org/10.1210/jc.2004-2169.CrossRefPubMed Chan CC, Ng EH, Tang OS, Yeung WS, Lau EY, Ho PC. A prospective, randomized, double-blind study to compare two doses of recombinant human chorionic gonadotropin in inducing final oocyte maturity and the hormonal profile during the luteal phase. J Clin Endocrinol Metab. 2005;90(7):3933–8. https://​doi.​org/​10.​1210/​jc.​2004-2169.CrossRefPubMed
18.
Zurück zum Zitat Chang P, Kenley S, Burns T, Denton G, Currie K, DeVane G, et al. Recombinant human chorionic gonadotropin (rhCG) in assisted reproductive technology: results of a clinical trial comparing two doses of rhCG (Ovidrel) to urinary hCG (Profasi) for induction of final follicular maturation in in vitro fertilization-embryo transfer. Fertil Steril. 2001;76(1):67–74.CrossRefPubMed Chang P, Kenley S, Burns T, Denton G, Currie K, DeVane G, et al. Recombinant human chorionic gonadotropin (rhCG) in assisted reproductive technology: results of a clinical trial comparing two doses of rhCG (Ovidrel) to urinary hCG (Profasi) for induction of final follicular maturation in in vitro fertilization-embryo transfer. Fertil Steril. 2001;76(1):67–74.CrossRefPubMed
22.
Zurück zum Zitat Provost MP, Acharya KS, Acharya CR, Yeh JS, Steward RG, Eaton JL, et al. Pregnancy outcomes decline with increasing recipient body mass index: an analysis of 22,317 fresh donor/recipient cycles from the 2008–2010 Society for Assisted Reproductive Technology Clinic Outcome Reporting System registry. Fertil Steril. 2016;105(2):364–8. https://doi.org/10.1016/j.fertnstert.2015.10.015.CrossRefPubMed Provost MP, Acharya KS, Acharya CR, Yeh JS, Steward RG, Eaton JL, et al. Pregnancy outcomes decline with increasing recipient body mass index: an analysis of 22,317 fresh donor/recipient cycles from the 2008–2010 Society for Assisted Reproductive Technology Clinic Outcome Reporting System registry. Fertil Steril. 2016;105(2):364–8. https://​doi.​org/​10.​1016/​j.​fertnstert.​2015.​10.​015.CrossRefPubMed
24.
Zurück zum Zitat Penarrubia J, Balasch J, Fabregues F, Creus M, Civico S, Vanrell JA. Recurrent empty follicle syndrome successfully treated with recombinant human chorionic gonadotrophin. Hum Reprod. 1999;14(7):1703–6.CrossRefPubMed Penarrubia J, Balasch J, Fabregues F, Creus M, Civico S, Vanrell JA. Recurrent empty follicle syndrome successfully treated with recombinant human chorionic gonadotrophin. Hum Reprod. 1999;14(7):1703–6.CrossRefPubMed
25.
Zurück zum Zitat Zegers-Hochschild F, Fernandez E, Mackenna A, Fabres C, Altieri E, Lopez T. The empty follicle syndrome: a pharmaceutical industry syndrome. Hum Reprod. 1995;10(9):2262–5.CrossRefPubMed Zegers-Hochschild F, Fernandez E, Mackenna A, Fabres C, Altieri E, Lopez T. The empty follicle syndrome: a pharmaceutical industry syndrome. Hum Reprod. 1995;10(9):2262–5.CrossRefPubMed
26.
Zurück zum Zitat Ludwig M, Doody KJ, Doody KM. Use of recombinant human chorionic gonadotropin in ovulation induction. Fertil Steril. 2003;79(5):1051–9.CrossRefPubMed Ludwig M, Doody KJ, Doody KM. Use of recombinant human chorionic gonadotropin in ovulation induction. Fertil Steril. 2003;79(5):1051–9.CrossRefPubMed
27.
Zurück zum Zitat Stelling JR, Chapman ET, Frankfurter D, Harris DH, Oskowitz SP, Reindollar RH. Subcutaneous versus intramuscular administration of human chorionic gonadotropin during an in vitro fertilization cycle. Fertil Steril. 2003;79(4):881–5.CrossRefPubMed Stelling JR, Chapman ET, Frankfurter D, Harris DH, Oskowitz SP, Reindollar RH. Subcutaneous versus intramuscular administration of human chorionic gonadotropin during an in vitro fertilization cycle. Fertil Steril. 2003;79(4):881–5.CrossRefPubMed
Metadaten
Titel
Human chorionic gonadotropin serum levels following ovulation triggering and IVF cycle outcome
verfasst von
Yossi Mizrachi
Eran Horowitz
Jacob Farhi
David Levran
Arieh Raziel
Ariel Weissman
Publikationsdatum
23.03.2018
Verlag
Springer US
Erschienen in
Journal of Assisted Reproduction and Genetics / Ausgabe 5/2018
Print ISSN: 1058-0468
Elektronische ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-018-1165-x

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