Ab. Copperman et al., RELATIONSHIP BETWEEN CIRCULATING HUMAN CHORIONIC-GONADOTROPIN LEVELS AND PREMATURE LUTEINIZATION IN CYCLES OF CONTROLLED OVARIAN HYPERSTIMULATION, Fertility and sterility, 63(6), 1995, pp. 1267-1271
Objective: To determine if premature luteinization (serum P levels > 1
.1 ng/mL on or before the day of hCG administration) during controlled
ovarian hyperstimulation (COH) is associated with elevated levels of
serum hCG. Setting: Tertiary fertility center. Design: Retrospective e
valuation of ovum donors undergoing COH. Patients: Forty-four women un
derwent COH. Comparisons of serum hCG levels and hormonal and cycle ch
aracteristics were made between cycles with premature luteinization (g
roup I) and without premature luteinization (group II). Results: Group
I (16 women) were similar to women in group II in age, amount of hMG,
and the ratio of FSH:hMG received. Both groups received hCG on simila
r days, but women in group I had higher peak E(2) levels. Serum hCG le
vels increased and correlated with serum P levels in group I only and
were higher on the day of hCG administration (group I 1.8 +/- 0.9 mIU/
mL versus group II 1.2 +/- 0.45 mIU/mL; conversion factor to SI unit,
1.00). Peak E(2) and LH levels, ampules of hMG and the FSH:LH ratio, a
nd day of hCG administration did not correlate with hCG levels. Human
chorionic gonadotropin exposure, as measured by area under the curve,
was significantly higher in group I compared with group II. Conclusion
: Higher serum levels of hCG and integrated hCG exposure are found in
COH cycles with premature luteinization compared with cycles without p
remature luteinization. Higher hCG levels may be due to decreased clea
rance of hCG from the circulation and/or the hCG content of hMG.