Recombinant HCG for triggering ovulation increases the rate of mature oocytes in women treated for ICSI

Abstract

Purpose To conduct a prospective randomized study in order to investigate the effect of recombinant HCG (rHCG) on oocyte nuclear and cytoplasm maturity compared to urinary HCG (uHCG), for inducing ovulation in women treated with ICSI for male factor infertility. Materials and Methods We compared 89 patients randomly assigned to one of the two study groups. Group A consisted of 42 women who received a subcutaneous (s.c.) injection of 250 μg rHCG and group B consisted of 47 patients receiving an intramuscular (i.m.) injection of 10,000 IU uHCG. Results Patients treated with rHCG showed a rate of metaphase II oocytes, a number of metaphase II oocytes with mature cytoplasm and a rate of metaphase II oocytes with mature cytoplasm calculated from total MII oocytes statistically higher than in patients treated with uHCG. However this differences were not associated with a significantly better clinical outcome. Conclusion Our data show that in women treated with ICSI for male factor infertility, rHCG increases the rate of metaphase II oocytes, the number and the rate of MII oocytes with mature cytoplasm compared to uHCG. A larger study comparing transfer cycles of embryos all derived from oocytes with mature cytoplasm and transfer cycles of embryos all derived from oocytes with immature cytoplasm may be needed to clarify clinical correlations.

Comparing the efficacy of urinary and recombinant hCG on oocyte/follicle ratio to trigger ovulation in women undergoing intracytoplasmic sperm injection cycles: a randomized controlled trial

“…Contrary to aforementioned studies, in some previous randomized trials, the oocytes quality was improved by administration of 250 μg rHCG rather than 5000 or 10,000 IU uhCG [12,27]. In contrast to two previous studies [13,28], we didn't find any superiority in administration of rhCG to uhCG in fertilization, implantation and pregnancy rates.…”

Recombinant or Urinary Human Chorionic Gonadotropin in Ovulation Induction?

“…The published data consistently show that single doses of 250 lg r-hCG and 5,000 IU u-hCG produce similar clinical outcomes when used in infertility treatment cycles for timed intercourse, IUI, and IVF in terms of the number of oocytes retrieved, number of mature oocytes harvested, and fertilization and pregnancy rates attained [8,10,12,13,17,19]. Single doses of 10,000 IU u-hCG also gave results comparable to single doses of 250 lg r-hCG [15].…”

“…P levels in the midluteal phase were significantly higher with the use of r-hCG compared with u-hCG, and local injection site adverse effects were significantly less frequent, demonstrating the higher purity of the recombinant product [11,12]. A single dose of 250 lg r-hCG was at least as effective as single doses of 5,000 or 10,000 IU u-hCG but offered the advantages associated with use of a recombinant product; local injection site adverse effects were significantly less frequent with r-hCG than with u-hCG [11][12][13]17].…”

“…Their results showed that r-hCG increases the rate of metaphase II oocytes, the number and the rate of MII oocytes with mature cytoplasm compared to u-hCG [13].…”

“…Farrag et al conducted a prospective randomized study in order to investigate the effect of r-hCG on oocyte nuclear and cytoplasm maturity compared to u-hCG, for inducing ovulation in women treated with ICSI for male factor infertility [13]. Their results showed that r-hCG increases the rate of metaphase II oocytes, the number and the rate of MII oocytes with mature cytoplasm compared to u-hCG [13].…”