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

Madani, Tahereh; Yeganeh, Ladan Mohammadi; Ezabadi, Zahra; Hasani, Fatemeh; Chehrazi, Mohammad

doi:10.1007/s10815-012-9919-3

Cited by 16 publications

(13 citation statements)

References 30 publications

(40 reference statements)

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“…A higher proportion of women experienced TEAEs with r‐hCG, compared with those who received u‐hCG (38.9% vs 29.6%, respectively). This result is different from those that have been reported previously by trials comparing r‐hCG with u‐hCG, which report significantly fewer AEs with r‐hCG . It should be noted that the incidence of AEs pre‐hCG administration was also higher in the group that received r‐hCG compared with the group that received u‐hCG.…”

Section: Discussioncontrasting

confidence: 99%

“…It should be noted that the incidence of AEs pre‐hCG administration was also higher in the group that received r‐hCG compared with the group that received u‐hCG. Furthermore, the overall incidence of OHSS that was observed in this study (14.8% in both arms) was higher than that reported in the literature or previous trials . This higher incidence might be because most studies only report moderate and severe OHSS, rather than all OHSS, and if the incidence of mild OHSS is removed, the hCG‐related OHSS rates are comparable with other studies (moderate or severe OHSS: 7.4% in both the r‐hCG and the u‐hCG treatment groups).…”

Section: Discussionsupporting

confidence: 57%

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Phase III trial comparing the efficacy and safety of recombinant‐ or urine‐derived human chorionic gonadotropin for ovulation triggering in Japanese women diagnosed with anovulation or oligo‐ovulation and undergoing ovulation induction with follitropin‐alfa

Ikenaga¹,

Tanaka²,

Shiotani

et al. 2016

Reprod Medicine & Biology

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AimOutside of Japan, recombinant‐human chorionic gonadotropin (r‐hCG) is widely used for the induction of final follicular maturation and early luteinization in women undergoing ovulation induction; whereas in Japan, urine‐derived hCG (u‐hCG) is predominantly used. The primary objective of this study was to demonstrate the non‐inferiority of r‐hCG to u‐hCG for ovulation induction, as assessed by the ovulation rate.MethodsThis was an open‐label, parallel‐group, randomized, multicenter, phase III trial in Japanese women with anovulation or oligo‐ovulation secondary to hypothalamic–pituitary dysfunction or polycystic ovary syndrome, undergoing ovulation induction with recombinant‐human follicle‐stimulating hormone. The women were randomized (2:1) to receive either a single 250 μg s.c. dose of r‐hCG or a single 5000 IU i.m. dose of u‐hCG for ovulation triggering.ResultsEighty‐one women were randomized to either r‐hCG (n=54) or u‐hCG (n=27). Ovulation occurred in 100% of the participants and treatment with r‐hCG was observed to be non‐inferior to u‐hCG for ovulation induction. Overall, the type and severity of adverse events were as expected for women receiving fertility treatment.ConclusionThis study demonstrated that r‐hCG was non‐inferior to u‐hCG for inducing ovulation. Furthermore, r‐hCG demonstrated an expected safety profile, with no new safety concerns identified.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 57%

Phase III trial comparing the efficacy and safety of recombinant‐ or urine‐derived human chorionic gonadotropin for ovulation triggering in Japanese women diagnosed with anovulation or oligo‐ovulation and undergoing ovulation induction with follitropin‐alfa

Ikenaga¹,

Tanaka²,

Shiotani

et al. 2016

Reprod Medicine & Biology

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“…Age, basal FSH, basal AMH, and AFC were included due to their importance in predicting oocyte yield. Parameters which potentially affect oocyte yield, including starting dose (< 150, 150, and 225 IU), BMI, addition of HMG [8], and the type of hCG (urinary or recombinant) [9] were also adjusted. All calculations were performed with SPSS (version 19; IBM).…”

Section: Discussionmentioning

confidence: 99%

Differential response of AMH to GnRH agonist among individuals: the effect on ovarian stimulation outcomes

Cai

Liu

Zheng

et al. 2017

J Assist Reprod Genet

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“…Some reports suggest that the proportion of metaphase II (MII) oocytes is significantly lower in small follicles (< 13 mm) than in large follicles (≥ 16 mm) (12,13). However, other studies found no differences between large follicles (> 18.5 mm) and small follicles (< 14.5 mm) in rates of immature oocyte development, fertilization, and cleavage (5,14). These inconsistent results regarding the dominant follicle size may be due to differences in patient characteristics.…”

Section: Introductionmentioning

confidence: 91%

“…COS treatment is based on an assumption that follicular size predicts the quality of oocyte development, fertilization, and cleavagestage embryo morphology (4,5). However, there is no consensus in the current literature as to an optimal follicle size for triggering.…”

Section: Introductionmentioning

confidence: 99%

Impact of follicular size categories on oocyte quality at trigger day in young and advanced-age patients undergoing GnRH-ant therapy

et al. 2023

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AimTo study the effect of follicle sizes of different proportions on oocyte and embryo quality in young and advanced-age patients, and provide evidence for personalized protocol adjustment.MethodsThis was a retrospective real-world data study including a total of 11,462 patients who had started their first in vitro fertilization cycle with a gonadotropin-releasing hormone antagonist (GnRH-ant) protocol during 2018–2021. We classified patients into groups according to the size of the dominant proportion of follicles on the human chorionic gonadotropin (hCG) trigger day: Large, Medium, Small, and Equal (containing equivalent proportions of all three size categories). The Cochran–Mantel–Haenszel test by different Anti-Mullerian Hormone (AMH) and antral follicle count (AFC) was used to compare factors such as the metaphase II (MII) oocyte rate, normal fertilization rate, and two pronuclei (2PN) cleavage rate between groups. General linear model (GLM) analysis was performed for inter-group comparison of the oocyte and embryo quality.ResultsIn patients aged < 35 years and with AMH ≥ 1.2μg/L, the MII oocyte percentages in the Large and Medium groups were significantly higher than in the Small group (P < 0.001). The germinal vesicle (GV) oocyte and unavailable oocyte percentages in the Large and Medium groups were lower than in the Small group (P < 0.001). Among patients aged ≥ 35 years with AFC < 5 and AMH ≥ 1.2μg/L, the GV oocyte percentage in the Large group was significantly lower than in the Medium group (2.54% vs. 4.46%, P < 0.001). In patients < 35 years, the GLM demonstrated that the Large and Medium groups had positively impacted on the development of MII oocyte and live birth rate(LBR) of first embryo transfer(ET)(β>0, all P value < 0.05);and had less likely to develop into unavailable oocyte, degenerated oocyte, GV oocyte and MI oocyte rates relative to the Small group(β<0, all P value < 0.05). And among patients ≥ 35 years, the Medium group had positively impacted on the development of MII oocyte and 2PN rates relative to the Small group(β>0, all P value < 0.05); and had less likely to develop into MI oocytes relative to the Small group(β<0, all P value < 0.05). The GLM indicated that AMH, along with Gn total dose, start dose, and Gn days, had significant impact on oocyte and embryo quality. For young patients, age was not a significant influencing factor, but for advanced-age patients, age influenced the outcomes.ConclusionOur analysis suggests that for young patients (< 35 years), triggering when there is a high proportion of large or medium follicles results in better quality oocytes, while for older patients (≥ 35 years), it is better to trigger when the proportion of medium follicles is no less than that of small follicles. Further research is required to confirm these findings.

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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

Cited by 16 publications

References 30 publications

Phase III trial comparing the efficacy and safety of recombinant‐ or urine‐derived human chorionic gonadotropin for ovulation triggering in Japanese women diagnosed with anovulation or oligo‐ovulation and undergoing ovulation induction with follitropin‐alfa

Phase III trial comparing the efficacy and safety of recombinant‐ or urine‐derived human chorionic gonadotropin for ovulation triggering in Japanese women diagnosed with anovulation or oligo‐ovulation and undergoing ovulation induction with follitropin‐alfa

Differential response of AMH to GnRH agonist among individuals: the effect on ovarian stimulation outcomes

Impact of follicular size categories on oocyte quality at trigger day in young and advanced-age patients undergoing GnRH-ant therapy

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