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Clinical Trial
. 2011 Sep;28(10):893-9.
doi: 10.1007/s10815-011-9612-y. Epub 2011 Jul 21.

The value of human chorionic gonadotropin stimulation test in predicting ovarian response during in-vitro fertilization

Assaf Ben-Meir  1 , David Shveiky, Einat Zivi, Tomer Feigenberg, Ariel Revel, Alex Simon, Neri Laufer
Affiliations
Clinical Trial

The value of human chorionic gonadotropin stimulation test in predicting ovarian response during in-vitro fertilization

Assaf Ben-Meir et al. J Assist Reprod Genet. 2011 Sep.

Abstract

Purpose: To assess the predictive value of human Chorionic Gonadotropin (hCG) theca-stimulation test for ovarian reserve in women undergoing in-vitro fertilization (IVF) treatments.

Methods: 39 women were included in the study. All participants received a single hCG 10000 IU injection on cycle day 2-3. Serum levels of estradiol, testosterone, androstenedione and 17-OH progesterone were measured prior to the injection and on days 1, 3 and 7 following the injection. hCG-induced hormone levels were compared with ovarian response during the subsequent IVF cycle.

Results: There were 11 good responders (>10 oocytes) and 22 low responders (<3 oocytes). Before hCG stimulation serum E2 levels were higher in low responders compared to good responders (370.3 ± 443 vs. 138.3 ± 54 pmol/ml). Following hCG stimulation, day 3 androstendione levels showed an increase in good responders compared to low responders. The ratio between day 3 androstendione and day 0 estradiol was significantly different between the two groups (p = 0.03). ROC analysis of this test revealed area = 0.837 (good prediction), which was much better than day 3 FSH (area = 0.635, poor prediction).

Conclusions: These preliminary results demonstrate the potential use of the hCG theca stimulation test in differentiating between good and poor responders. Larger series are needed for further verification of the test in routine clinical application.

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Figures

Fig. 1
Fig. 1
Serum steroid levels before and 1, 3 and 7 days after hCG stimulation test from poor and good responders (mean ± SE)
Fig. 2
Fig. 2
Box plot of the ratio of the proportional increase in androstenedione at day 3 to baseline estradiol (A3/A0)/E0) in poor and good responders
Fig. 3
Fig. 3
Pearson correlation coefficient of FSH and hCG-stimulation test to the number of oocytes retrieved
Fig. 4
Fig. 4
Areas under the ROC curves evaluating the prediction of low responders by hCG stimulation test and day 3 FSH
See this image and copyright information in PMC

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