Controlled ovarian stimulation with exclusive FSH followed by stimulation with hCG alone, FSH alone or hMG

Low-dose human chorionic gonadotropin may improve in vitro fertilization cycle outcomes in patients with low luteinizing hormone levels after gonadotropin-releasing hormone antagonist administration

“…The LH/hCG activity increases the activity of the enzymes involved in steroid production, leading to increased substrate for conversion to estradiol. Several randomized controlled trials have also confirmed this positive association with hMG, recombinant LH, and hCG and increased peak estradiol levels (12,13,15,26,28,29,(34)(35)(36)(37)(38)(39)(40)(41)63). Our study is consistent with these data in demonstrating that the addition of LH activity decreases the overall oocyte yield and increases the peak estradiol levels.…”

The Use of rLH, HMG and hCG in Controlled Ovarian Stimulation for Assisted Reproductive Technologies

“…A study by Filicori et al further demonstrated a significantly higher fertilization rate in patients receiving hCG versus rFSH only (74% versus 48%) (104). The remainder of the trials did not show any differences in outcomes with hCG with regards to fertilization, implantation, or pregnancy (105)(106)(107)109). These RCT total 614 patients and demonstrate that the addition of hCG results in higher estradiol levels and at least comparable ART outcomes to rFSH stimulation only.…”

“…All trials were initiated with rFSH only for stimulation with hCG added when the follicles were between 12-14mm in size. Five of the trials reported a significantly higher estradiol level on the day of hCG in patients randomized to receive hCG stimulation, with increases in estradiol ranging from 700-1500 pg/ml (104)(105)(106)(107)109). A study by Filicori et al further demonstrated a significantly higher fertilization rate in patients receiving hCG versus rFSH only (74% versus 48%) (104).…”

“…The dose of hCG utilized was 200IU per day in five trials and 250IU in another (104)(105)(106)(107)(108)(109). All trials were initiated with rFSH only for stimulation with hCG added when the follicles were between 12-14mm in size.…”

Efficacy and safety of human chorionic gonadotropin for follicular phase stimulation in assisted reproduction: a systematic review and meta-analysis

“…Eleven RCTs evaluating hCG during the period of follicular stimulation in women undergoing assisted reproduction met the inclusion criteria (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). The sample size ranged from 20 to 300 women, with a total of 1,068 women.…”