The effects of low‐dose human chorionic gonadotropin combined with human menopausal gonadotropin protocol on women with hypogonadotropic hypogonadism undergoing ovarian stimulation for in vitro fertilization

Jiang, Shutian; Kuang, Yanping

doi:10.1111/cen.13481

Cited by 11 publications

(8 citation statements)

References 26 publications

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“…Our results suggested that the addition of 150 IU of hCG in early follicle phase could provide a better clinical outcome compared with that in mid-late phase addition. Our results were in line with previous studies that the addition of LH/hCG could increase oocyte number and E 2 production (15,16). A meta-analysis confirmed that the use of rLH/hCG increased the peak E 2 levels and oocyte number and improved embryo quality and, therefore, enhanced implantation rate (17).…”

Section: Discussionsupporting

confidence: 92%

Early Follicular Phase Human Chorionic Gonadotropin Addition May Improve the Outcomes of In Vitro Fertilization/Intracytoplasmic Sperm Injection in Patients With “Unpredictable” Poor Response to Gonadotropin-Releasing Hormone Antagonist Protocol

Zhang

et al. 2021

Front. Endocrinol.

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PurposeTo compare the effects of early and mid-late follicular phase administration of 150 IU of human chorionic gonadotropin (hCG) on gonadotropin-releasing hormone (GnRH) antagonist protocol in “unpredictable” poor ovarian response (POR) women undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment.MethodsA retrospective single-center cohort study was conducted on 67 patients with “unpredictable” POR in their first IVF/ICSI cycle receiving GnRH antagonist protocol. Patients were treated with a second IVF/ICSI cycle using the same GnRH antagonist protocol with the same starting dose of recombinant follicle-stimulating hormone (rFSH) as the first cycle; a daily dose of 150 IU of hCG was administrated on either stimulation day 1 (Group A, n = 35) or day 6 (Group B, n = 32). The number of oocytes retrieved, number of usable embryos, serum level of estradiol (E2) on day of hCG trigger, and clinical pregnant outcomes were studied.ResultsThe addition of 150 IU of hCG on either the first day or sixth day of stimulation increases the serum level of E2, luteinizing hormone (LH), and hCG on the day of hCG trigger. Only the use of 150 IU of hCG on the first stimulation day improved the number of oocytes retrieved, mature of oocytes, and usable embryos, but not the addition of hCG on stimulation day 6. Implantation rate, clinical pregnancy rate, and ongoing pregnancy rate showed an increasing trend in patients receiving 150 IU of hCG in the early phase compared with mid-late phase, even thought there was no statistically significant difference.ConclusionsOur study demonstrated that adding 150 IU of hCG in subsequent GnRH antagonist cycle in “unpredictable” poor responders is associated with the improvement of response to stimulation. Furthermore, early follicular phase addition of 150 IU of hCG significantly increased the number of oocytes retrieved and usable embryos than did the mid-late addition of the same dose.

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Section: Discussionsupporting

confidence: 92%

Early Follicular Phase Human Chorionic Gonadotropin Addition May Improve the Outcomes of In Vitro Fertilization/Intracytoplasmic Sperm Injection in Patients With “Unpredictable” Poor Response to Gonadotropin-Releasing Hormone Antagonist Protocol

Zhang

et al. 2021

Front. Endocrinol.

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“…COS protocols for assisted reproduction in women with HH are described in Table 3. The reported pregnancy rates after COS amongst HH women vary wildly, from 19.4 to 100%, with a 3.6-41.7% risk of multiple pregnancies [88][89][90][95][96][97][98][99][100]. Higher gonadotropin doses are generally used than in patients with other causes of infertility [101].…”

Section: Female Infertilitymentioning

confidence: 99%

Late Effects of Parasellar Lesion Treatment: Hypogonadism and Infertility

et al. 2020

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Central hypogonadism, also defined as hypogonadotropic hypogonadism, is a recognized complication of hypothalamic-pituitary-gonadal axis damage following treatment of sellar and parasellar masses. In addition to radiotherapy and surgery, CTLA4-blocking antibodies and alkylating agents such as temozolomide can also lead to hypogonadism, through different mechanisms. Central hypogonadism in boys and girls may lead to pubertal delay or arrest, impairing full development of the genitalia and secondary sexual characteristics. Alternatively, cranial irradiation or ectopic hormone production may instead cause early puberty, affecting hypothalamic control of the gonadostat. Given the reproductive risks, discussion of fertility preservation options and referral to reproductive specialists before treatment is essential. Steroid hormone replacement can interfere with other replacement therapies and may require specific dose adjustments. Adequate gonadotropin stimulation therapy may enable patients to restore gametogenesis and conceive spontaneously. When assisted reproductive technology is needed , protocols must be tailored to account for possible long-term gonadotropin insufficiency prior to stimulation. The aim of this review was to provide an overview of the risk factors for hypogonadism and infertility in patients treated for parasellar lesions and to give a summary of the current recommendations for management and follow-up of these dysfunctions in such patients. We have also briefly summarized evidence on the physiological role of pituitary hormones during pregnancy, focusing on the management of pituitary deficiencies.

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“…Another study with HH patients due to multiple etiologies also reported lower AFC [2]. However, many authors reported normal follicular count, but these results could be explained by the type of patients in the studies where women with small-sized ovaries who showed multi follicular or normal-sized ovaries as in cases of functional hypogonadism were included [9].…”

Section: Discussionmentioning

confidence: 99%

“…Hypogonadotrophic hypogonadism (HH) diagnosis was based on clinical history of primary or secondary amenorrhea, negative progestin challenge, serum levels of both FSH and luteinizing hormone (LH) < 5 IU/L, accompanied by serum estradiol levels below 20 pg/mL [2].…”

Section: Introductionmentioning

confidence: 99%

Reproductive outcomes in women with hypogonadotrophic hypogonadism, a case series study

Abdelaal

Behery

Abdel-Kawi

2021

Middle East Fertil Soc J

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Background Hypogonadotropic hypogonadism (HH) is a rare condition in which there is gonadal hypofunction due to absence of gonadotropin drive. In this condition, there are very low serum levels of gonadotropins. Pituitary gland may itself have some disease or disorder, or there may be loss of gonadotropin-releasing hormone (GnRH) pulses from the hypothalamus. The pharmacological interventions in HH women formed the basis for superovulation strategies for assisted reproduction techniques (ART) with a special reference to the role of LH and its impact on oocyte and embryo quality. Results The medians ±inter quartile ranges for number of oocytes retrieved, number of MII oocytes, and number of embryos transferred were 5±7, 4±3, and 3±1 respectively. The pregnancy rate was 31.5% for this group of patients. The live birth rate and miscarriage rate were 21% and 11.5% respectively. Conclusion The reproductive outcomes of patients of hypogonadotrophic hypogonadism are reasonable after ICSI and clinical trials are recommended to corroborate this concern.

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The effects of low‐dose human chorionic gonadotropin combined with human menopausal gonadotropin protocol on women with hypogonadotropic hypogonadism undergoing ovarian stimulation for in vitro fertilization

Cited by 11 publications

References 26 publications

Early Follicular Phase Human Chorionic Gonadotropin Addition May Improve the Outcomes of In Vitro Fertilization/Intracytoplasmic Sperm Injection in Patients With “Unpredictable” Poor Response to Gonadotropin-Releasing Hormone Antagonist Protocol

Early Follicular Phase Human Chorionic Gonadotropin Addition May Improve the Outcomes of In Vitro Fertilization/Intracytoplasmic Sperm Injection in Patients With “Unpredictable” Poor Response to Gonadotropin-Releasing Hormone Antagonist Protocol

Late Effects of Parasellar Lesion Treatment: Hypogonadism and Infertility

Reproductive outcomes in women with hypogonadotrophic hypogonadism, a case series study

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