"hCG priming" effect in controlled ovarian stimulation through a long protocol

Abstract

Background: Recently, it has been demonstrated that, in patients down-regulated by GnRH analogues (GnRHa), a short-term pre-treatment with recombinant LH (rLH), prior to recombinant FSH (rFSH) administration, increases the number of small antral follicle prior to FSH stimulation and the yield of normally fertilized embryos. However, no data exist in the literature regarding the potential beneficial effect of "hCG priming" in controlled ovarian hyperstimulation (COH) through a long GnRH-a protocol, which binds the same receptor (LH/hCGR), though it is a much more potent compared to LH. The primary aims of this study were to assess the effect of short-term pre-rFSH administration of hCG in women entering an ICSI treatment cycle on follicular development, quality of oocytes and early embryo development. The secondary endpoints were to record the effects on endometrial quality and pregnancy rate.

Efficacy of luteal phase support with vaginal progesterone in intrauterine insemination: a systematic review and meta-analysis

“…Statistical significance was set at a P value <.01. We evaluated the degree of variation across studies attributable to heterogeneity with the I 2 statistic [17]. We conducted the meta-analysis using Review Manager software …”

Androgens and poor responders: are we ready to take the plunge into clinical therapy?

“…Further studies are, therefore, required to examine the possible effects of longer and/ or more powerful pretreatments using higher doses of LH or hCG, a hormone whose biopotency is higher than that of LH. Indeed, in pilot studies, some investigators have obtained encouraging results with the use of hCG instead of LH before COH (42,43).…”

“…Yet, this approach depends on the amount of androgens that effectively become available to ovarian follicles. The other approach that can be used to increase intraovarian androgen availability is to stimulate thecal production by administering LH activity (LH or hCG) (41)(42)(43). A third possibility to increase intraovarian androgens is the use of aromatase inhibitors (44)(45)(46)(47) to prevent androgen metabolism into estrogens.…”

The Use of rLH, HMG and hCG in Controlled Ovarian Stimulation for Assisted Reproductive Technologies

“…Two studies have reported the use of hCG in the early follicular phase of ovarian stimulation (100,101). These trials and two case reports have used various dosing strategies to deliver the hCG, including 200 IU per day for four or seven days, 50 IU per day for 14 days, and 1,250 IU in a single dose on cycle day two (100-103).…”