Abstract
Research question: Is there an association between the ovulation trigger dose of human chorionic gonadotrophin (HCG) and endogenous progesterone production during the luteal phase? Design: This randomized controlled four-arm study, at the Fertility Clinic, Odense University Hospital, Denmark, included women undergoing gonadotrophin-releasing hormone (GnRH) antagonist IVF treatment with ≤11 follicles ≥12 mm. Group 1–3 were triggered with 5000 IU, 6500 IU or 10,000 IU HCG, respectively, receiving 17α-hydroxyprogesterone caproate intramuscularly for luteal-phase support (LPS) to measure endogenous progesterone production. Group 4 received 6500 IU HCG trigger and vaginal progesterone. During the study, the 5000 IU and 10,000 IU HCG groups were switched from urinary to recombinant HCG, as urinary HCG was removed from market. Eight blood samples were drawn during the luteal phase. Results: Ninety-four participants completed the study. There was a significant positive association between the HCG trigger dose and the progesterone at 8 days (P < 0.001), 10 days (P < 0.001) and 14 days (P < 0.001) post-oocyte retrieval. Comparing the groups individually revealed a significant difference in progesterone concentration between low and high trigger doses at 4 days (P = 0.037) and 8 days (P = 0.007) post-oocyte retrieval and between all intervention groups at oocyte retrieval + 6 days: group 1 and 2 (P = 0.011), group 2 and 3 (P = 0.042) and group 1 and 3 (P < 0.001). Higher HCG trigger dose increased the progesterone from the individual follicle. Conclusions: Increasing HCG trigger doses significantly increased endogenous progesterone concentration during the mid–late luteal phase.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Reproductive BioMedicine Online |
| Vol/bind | 45 |
| Udgave nummer | 4 |
| Sider (fra-til) | 793-804 |
| Antal sider | 12 |
| ISSN | 1472-6483 |
| DOI | |
| Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:An unrestricted grant was given by NordicInfu Care, Sweden, and grants were received from the University of South of Denmark, Region of South of Denmark, OPEN, and the Research Fund of chief doctor committee OUH. The funding providers were not involved in conducting the study or writing or approval of the manuscript.
Funding Information:
The authors thank all the infertile couples who participated in this study. Moreover, they thank the doctors, nurses and laboratory staff from the Fertility Clinic, Odense University Hospital for their active participation in the study. The authors acknowledge OPEN and the biochemical department at Odense University Hospital for assistance in biobanking and analysing blood samples. Finally, thanks goes to IBSA and NordicInfu Care for providing Lentogest. An unrestricted grant was given by NordicInfu Care, Sweden, and grants were received from the University of South of Denmark, Region of South of Denmark, OPEN, and the Research Fund of chief doctor committee OUH. The funding providers were not involved in conducting the study or writing or approval of the manuscript.
Publisher Copyright:
© 2022