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• W2107173677 abstract "Objective(s)It has previously been demonstrated that low dose HCG (200 IU) is capable of completing controlled ovarian hyperstimulation after FSH priming. We hypothesized that this approach could be applied to follicle maturity in the natural cycle. We used the unstimulated IVF model to demonstrate follicle maturity by ultrasound, E2 levels, and retrieval of a mature oocyte.DesignProspective review of unstimulated IVF patients.Materials and Method(s)Twelve patients, with a mean age of 33.6±4.4 years were monitored in a natural cycle until the lead follicle was [ge] 14 mm and E2 exceeded 100 pg/mL. Ganirelix acetate (GA) 0.25 mg was administered along with 200 IU of HCG daily. When the lead follicle reached 18 mm and E2 neared or exceeded 200 pg/mL, ovulation was triggered with 10,000 IU of HCG and follicle aspiration was accomplished 34 hours later. Dominant and secondary follicles were aspirated. Fertilization of mature oocytes was achieved by co-incubation with sperm or by ICSI. Immature oocytes were allowed to mature overnight and were inseminated or subjected to ICSI if mature the next day. Embryo transfer was performed on day 3.Result(s)In all but two cases, serum E2 levels rose after GA and HCG administration. In all cases, the dominant follicle increased in size. The mean increase in E2 level from the day the GA and HCG administration started until the day of the HCG trigger was 77.5±51.7 pg/ml. The mean increase in diameter of the dominant follicle during this time was 3.4±1.1 mm. In all but two cases, a mature oocyte was retrieved from the dominant follicle and normal fertilization was achieved. Of the twelve patients, ten had embryo transfers. Of those, two resulted in a singleton live birth,one has an ongoing pregnancy three had biochemical pregnancies and the other four had negative pregnancy tests.Conclusion(s)We conclude that HCG alone can complete follicle maturity in the late follicular phase of a natural cycle after GA blockade of pituitary gonadotropin secretion. Furthermore, mature oocytes can be retrieved after HCG ovulation triggering, leading to successful pregnancies, thus suggesting a possible application in a clinical setting. Objective(s)It has previously been demonstrated that low dose HCG (200 IU) is capable of completing controlled ovarian hyperstimulation after FSH priming. We hypothesized that this approach could be applied to follicle maturity in the natural cycle. We used the unstimulated IVF model to demonstrate follicle maturity by ultrasound, E2 levels, and retrieval of a mature oocyte. It has previously been demonstrated that low dose HCG (200 IU) is capable of completing controlled ovarian hyperstimulation after FSH priming. We hypothesized that this approach could be applied to follicle maturity in the natural cycle. We used the unstimulated IVF model to demonstrate follicle maturity by ultrasound, E2 levels, and retrieval of a mature oocyte. DesignProspective review of unstimulated IVF patients. Prospective review of unstimulated IVF patients. Materials and Method(s)Twelve patients, with a mean age of 33.6±4.4 years were monitored in a natural cycle until the lead follicle was [ge] 14 mm and E2 exceeded 100 pg/mL. Ganirelix acetate (GA) 0.25 mg was administered along with 200 IU of HCG daily. When the lead follicle reached 18 mm and E2 neared or exceeded 200 pg/mL, ovulation was triggered with 10,000 IU of HCG and follicle aspiration was accomplished 34 hours later. Dominant and secondary follicles were aspirated. Fertilization of mature oocytes was achieved by co-incubation with sperm or by ICSI. Immature oocytes were allowed to mature overnight and were inseminated or subjected to ICSI if mature the next day. Embryo transfer was performed on day 3. Twelve patients, with a mean age of 33.6±4.4 years were monitored in a natural cycle until the lead follicle was [ge] 14 mm and E2 exceeded 100 pg/mL. Ganirelix acetate (GA) 0.25 mg was administered along with 200 IU of HCG daily. When the lead follicle reached 18 mm and E2 neared or exceeded 200 pg/mL, ovulation was triggered with 10,000 IU of HCG and follicle aspiration was accomplished 34 hours later. Dominant and secondary follicles were aspirated. Fertilization of mature oocytes was achieved by co-incubation with sperm or by ICSI. Immature oocytes were allowed to mature overnight and were inseminated or subjected to ICSI if mature the next day. Embryo transfer was performed on day 3. Result(s)In all but two cases, serum E2 levels rose after GA and HCG administration. In all cases, the dominant follicle increased in size. The mean increase in E2 level from the day the GA and HCG administration started until the day of the HCG trigger was 77.5±51.7 pg/ml. The mean increase in diameter of the dominant follicle during this time was 3.4±1.1 mm. In all but two cases, a mature oocyte was retrieved from the dominant follicle and normal fertilization was achieved. Of the twelve patients, ten had embryo transfers. Of those, two resulted in a singleton live birth,one has an ongoing pregnancy three had biochemical pregnancies and the other four had negative pregnancy tests. In all but two cases, serum E2 levels rose after GA and HCG administration. In all cases, the dominant follicle increased in size. The mean increase in E2 level from the day the GA and HCG administration started until the day of the HCG trigger was 77.5±51.7 pg/ml. The mean increase in diameter of the dominant follicle during this time was 3.4±1.1 mm. In all but two cases, a mature oocyte was retrieved from the dominant follicle and normal fertilization was achieved. Of the twelve patients, ten had embryo transfers. Of those, two resulted in a singleton live birth,one has an ongoing pregnancy three had biochemical pregnancies and the other four had negative pregnancy tests. Conclusion(s)We conclude that HCG alone can complete follicle maturity in the late follicular phase of a natural cycle after GA blockade of pituitary gonadotropin secretion. Furthermore, mature oocytes can be retrieved after HCG ovulation triggering, leading to successful pregnancies, thus suggesting a possible application in a clinical setting. We conclude that HCG alone can complete follicle maturity in the late follicular phase of a natural cycle after GA blockade of pituitary gonadotropin secretion. Furthermore, mature oocytes can be retrieved after HCG ovulation triggering, leading to successful pregnancies, thus suggesting a possible application in a clinical setting." @default.
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• W2107173677 date "2013-03-01" @default.
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• W2107173677 title "Low-dose HCG Can Complete Follicle Maturity: The Unstimulated IVF Model" @default.
• W2107173677 doi "https://doi.org/10.1016/j.fertnstert.2013.01.062" @default.
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