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
M. Jinno et al., 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, Fertility and sterility, 63(4), 1995, pp. 859-865
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.