ADMINISTRATION OF HUMAN CHORIONIC-GONADOTROPIN FOR IN-VITRO FERTILIZATION-EMBRYO TRANSFER BASED ON THE SERUM LUTEINIZING-HORMONE (LH) CONCENTRATION - THE IMPORTANCE OF SYNCHRONIZATION WITH ENDOGENOUS LH RISES

Objective: To examine whether synchronized administration of hCG at th e onset of the endogenous LH rise promotes successful IVF. Design: A p rospective randomized study. Setting: In vitro fertilization program a t a university hospital. Patients: A total of 208 IVF cycles in 148 pa tients. Interventions: Serum LH concentrations were measured daily and hMG was administered daily. Independent of follicle size and E(2) con centration, hCG was administered as soon as the LH concentration excee ded the J level, defined as the minimum value + (the day 3 value - the minimum value) X 1/3(J group). Alternatively, hCG was administered wh en the serum LH concentration turned to increase but was still less th an the J level, or 1 day after the serum LH concentration exceeded the J level (non-J group). Results: The rates of total and ongoing pregna ncy per cycle were significantly higher in the J group (35.6% and 26.0 %, respectively, n = 104) than in the non-J group (21.2% and 12.5%, re spectively, n = 104). Pregnancies in the J group were achieved over a wide range of dominant follicle diameters (13 to 25 mm), E(2) levels ( 198 to 1,700 pg/mL; conversion factor to SI units, 3.671), and E(2) le vel per follicle greater than or equal to 12 mm (24 to 225 pg/mL per f ollicle) recorded on the day of hCG administration. Conclusion: Synchr onized administration of hCG in accordance with endogenous LH rises pr oduces a high rate of pregnancy in IVF.