Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2009 Aug 31:7:91.
doi: 10.1186/1477-7827-7-91.

"hCG priming" effect in controlled ovarian stimulation through a long protocol

Panagiotis Beretsos  1 , George A Partsinevelos, Eleni Arabatzi, Peter Drakakis, Depy Mavrogianni, Elli Anagnostou, Kostas Stefanidis, Aris Antsaklis, Dimitris Loutradis
Affiliations
Randomized Controlled Trial

"hCG priming" effect in controlled ovarian stimulation through a long protocol

Panagiotis Beretsos et al. Reprod Biol Endocrinol. .

Abstract

Background: Recently, it has been demonstrated that, in patients down-regulated by GnRH analogues (GnRHa), a short-term pre-treatment with recombinant LH (rLH), prior to recombinant FSH (rFSH) administration, increases the number of small antral follicle prior to FSH stimulation and the yield of normally fertilized embryos. However, no data exist in the literature regarding the potential beneficial effect of "hCG priming" in controlled ovarian hyperstimulation (COH) through a long GnRH-a protocol, which binds the same receptor (LH/hCGR), though it is a much more potent compared to LH. The primary aims of this study were to assess the effect of short-term pre-rFSH administration of hCG in women entering an ICSI treatment cycle on follicular development, quality of oocytes and early embryo development. The secondary endpoints were to record the effects on endometrial quality and pregnancy rate.

Methods: Patients with a history of at least one previous unsuccessful ICSI cycle were randomly assigned into two groups to receive treatment with either a long protocol with rFSH (control group) or a long protocol with rFSH and pre-treatment with hCG (hCG group). In particular, in the latter group, a fixed 7 days course of 200 IU/day hCG was administered as soon as pituitary desensitization was confirmed.

Results: The mean number of oocytes retrieved was not significantly different between the two treatment groups, although the percentage of mature oocytes tended to be higher but not significantly different in hCG-treated patients. The percentage of patients with more than one grade 3 embryos was higher in the pre-treatment group, which also showed a higher pregnancy rate.

Conclusion: All the above clinical observations, in conjunction with previous data, suggest a point towards a beneficial "hCG priming" effect in controlled ovarian hyperstimulation through a long GnRH-a down-regulation protocol, particularly in patients with previous ART failures.

PubMed Disclaimer

References

    1. Loutradis D, Drakakis P, Vomvolaki E, Antsaklis A. Different ovarian stimulation protocols for women with diminished ovarian reserve. J Assist Reprod Genet. 2007;24:597–611. doi: 10.1007/s10815-007-9181-2. - DOI - PMC - PubMed
    1. Hillier SG. Gonadotropic control of ovarian follicular growth and development. Mol Cell Endocrinol. 2001;179:39–46. doi: 10.1016/S0303-7207(01)00469-5. - DOI - PubMed
    1. Lossl K, Andersen AN, Loft A, Freiesleben NL, Bangsboll S, Andersen CY. Androgen priming using aromatase inhibitor and hCG during early-follicular-phase GnRH antagonist down-regulation in modified antagonist protocols. Hum Reprod. 2006;21:2593–2600. doi: 10.1093/humrep/del221. - DOI - PubMed
    1. Shoham Z, Schacter M, Loumaye E, Weissman A, MacNamee M, Insler V. The luteinizing hormone surge - the final stage in ovulation induction: modern aspects of ovulation triggering. Fertil Steril. 1995;64:237–251. - PubMed
    1. Ferraretti AP, Gianaroli L, Magli MC, D'Angelo A, Farfalli V, Montanaro N. Exogenous luteinizing hormone in controlled ovarian hyperstimulation for assisted reproduction techniques. Fertil Steril. 2004;82:1521–1526. doi: 10.1016/j.fertnstert.2004.06.041. - DOI - PubMed

Publication types

Substances