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Advancing or postponing the day of human chorionic gonadotropin does not matter for the outcome in assisted reproductive technology.

Pratap D, Kumar P, Adiga SK - J Hum Reprod Sci (2014)

Bottom Line: Kruskal-Wallis test.The average number of >18 mm follicles observed from day 8-11 of hCG administration was not statistically different.The day of hCG administration between 8 and 11 does not affect the OR rate significantly although the number of oocytes recovered on day 8 are marginally higher compared with day 9-11.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.

ABSTRACT

Context: The primary outcome is to remove the worry of getting immature oocytes with early administration of human chorionic gonadotropin (hCG).

Aim: The aim was to find out the association between the day of hCG administration and follicular response in relation to the number and maturity of oocytes, and fertilization rate in assisted reproduction to avoid weekend oocyte recovery (OR).

Settings and design: Retrospective study was carried out in the university infertility clinic.

Materials and method: Controlled ovarian hyperstimulation (COH) in 94 patients undergoing assisted reproductive technology (2010-2011) with recombinant follicle stimulating hormone and timely gonadotropin-releasing hormone antagonist were analyzed regarding day of hCG from day 8-11. Oocyte maturity and fertilization was analyzed and correlated with the day of hCG administration.

Statistical analysis: Kruskal-Wallis test.

Results: The average number of >18 mm follicles observed from day 8-11 of hCG administration was not statistically different. However, the OR rate (54.2%), number of mature oocytes (92.5%), and fertilization rate (78.5%) was maximum in the patients where hCG was administered on day 8 of COH.

Conclusions: The day of hCG administration between 8 and 11 does not affect the OR rate significantly although the number of oocytes recovered on day 8 are marginally higher compared with day 9-11. Hence, it is possible to safely avoid weekend oocyte retrieval, by delaying or advancing hCG administration without compromising the outcome.

No MeSH data available.


Related in: MedlinePlus

Oocyte recovery rate and day of human chorionic gonadotropin
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Related In: Results  -  Collection

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Figure 3: Oocyte recovery rate and day of human chorionic gonadotropin

Mentions: The mean number of total follicles tapped was the lowest on day 8 (10.75), compared to day 9 (16.9), day 10 (16.0) and day 11 (17.5) [Figure 1]. The average number of >18 mm follicles observed from day 8-11 of hCG administration was not statistically different. However, the mean number of follicles of 14-18 mm size was approximately 4.5 on day 8, which then increased to 8.0 on day 9, 7.3 on day 10 and 8.7 on day 11 [Figure 2]. This shows that on delaying the administration of hCG, the mature follicles were not significantly different, though there was a rise in immature follicle from day 8 to day 9, 10 and 11. As shown in Figure 3, the highest OR rate was observed on day 8 (54.2%) of hCG administration, compared with day 9, 10, 11 which were 47.6%, 46.7%, and 45.1%. As the days progressed, it appeared that there was a decline in the OR rate which was statistically not significant. As shown in Table 1, the mean percentage of GV oocytes was more on day 11 (8.5%, standard error of mean [SEM] =4.4), when compared to day 8 (6.7%, SEM = 3.5), day 9 (7.1%, SEM = 12.9), day 10 (4.5%, SEM = 1.5). As the SEM was high in all the values, it was not statistically significant. The mean percentage of MI oocyte retrieved, was 0.83% (SEM = 0.83) on day 8, 5.18% on day 9 (SEM = 8.89), 6.15% on day 10 (SEM = 2.08) and 7.52% (SEM = 4.93) on day 11. This was not statistically significant. The number of MII oocytes was the highest on day 8 (92.5%, SEM = 3.8), when compared to day 9, 10 and 11 which were 87.7% (SEM = 15.4), 89.3% (SEM = 2.7%), and 83.9% (SEM = 6.0), though it is not statistically significant. The maximum fertilization rate (78.5%) was observed in the patients where hCG was administered on day 8, when compared to 71% on day 9, 76.4% on day 10 and 66.6% on day 11 [Table 1]. This was not statistically significant. An extra day of antagonist did not show any ill-effect on ovarian stimulation or pregnancy rates.


Advancing or postponing the day of human chorionic gonadotropin does not matter for the outcome in assisted reproductive technology.

Pratap D, Kumar P, Adiga SK - J Hum Reprod Sci (2014)

Oocyte recovery rate and day of human chorionic gonadotropin
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150136&req=5

Figure 3: Oocyte recovery rate and day of human chorionic gonadotropin
Mentions: The mean number of total follicles tapped was the lowest on day 8 (10.75), compared to day 9 (16.9), day 10 (16.0) and day 11 (17.5) [Figure 1]. The average number of >18 mm follicles observed from day 8-11 of hCG administration was not statistically different. However, the mean number of follicles of 14-18 mm size was approximately 4.5 on day 8, which then increased to 8.0 on day 9, 7.3 on day 10 and 8.7 on day 11 [Figure 2]. This shows that on delaying the administration of hCG, the mature follicles were not significantly different, though there was a rise in immature follicle from day 8 to day 9, 10 and 11. As shown in Figure 3, the highest OR rate was observed on day 8 (54.2%) of hCG administration, compared with day 9, 10, 11 which were 47.6%, 46.7%, and 45.1%. As the days progressed, it appeared that there was a decline in the OR rate which was statistically not significant. As shown in Table 1, the mean percentage of GV oocytes was more on day 11 (8.5%, standard error of mean [SEM] =4.4), when compared to day 8 (6.7%, SEM = 3.5), day 9 (7.1%, SEM = 12.9), day 10 (4.5%, SEM = 1.5). As the SEM was high in all the values, it was not statistically significant. The mean percentage of MI oocyte retrieved, was 0.83% (SEM = 0.83) on day 8, 5.18% on day 9 (SEM = 8.89), 6.15% on day 10 (SEM = 2.08) and 7.52% (SEM = 4.93) on day 11. This was not statistically significant. The number of MII oocytes was the highest on day 8 (92.5%, SEM = 3.8), when compared to day 9, 10 and 11 which were 87.7% (SEM = 15.4), 89.3% (SEM = 2.7%), and 83.9% (SEM = 6.0), though it is not statistically significant. The maximum fertilization rate (78.5%) was observed in the patients where hCG was administered on day 8, when compared to 71% on day 9, 76.4% on day 10 and 66.6% on day 11 [Table 1]. This was not statistically significant. An extra day of antagonist did not show any ill-effect on ovarian stimulation or pregnancy rates.

Bottom Line: Kruskal-Wallis test.The average number of >18 mm follicles observed from day 8-11 of hCG administration was not statistically different.The day of hCG administration between 8 and 11 does not affect the OR rate significantly although the number of oocytes recovered on day 8 are marginally higher compared with day 9-11.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.

ABSTRACT

Context: The primary outcome is to remove the worry of getting immature oocytes with early administration of human chorionic gonadotropin (hCG).

Aim: The aim was to find out the association between the day of hCG administration and follicular response in relation to the number and maturity of oocytes, and fertilization rate in assisted reproduction to avoid weekend oocyte recovery (OR).

Settings and design: Retrospective study was carried out in the university infertility clinic.

Materials and method: Controlled ovarian hyperstimulation (COH) in 94 patients undergoing assisted reproductive technology (2010-2011) with recombinant follicle stimulating hormone and timely gonadotropin-releasing hormone antagonist were analyzed regarding day of hCG from day 8-11. Oocyte maturity and fertilization was analyzed and correlated with the day of hCG administration.

Statistical analysis: Kruskal-Wallis test.

Results: The average number of >18 mm follicles observed from day 8-11 of hCG administration was not statistically different. However, the OR rate (54.2%), number of mature oocytes (92.5%), and fertilization rate (78.5%) was maximum in the patients where hCG was administered on day 8 of COH.

Conclusions: The day of hCG administration between 8 and 11 does not affect the OR rate significantly although the number of oocytes recovered on day 8 are marginally higher compared with day 9-11. Hence, it is possible to safely avoid weekend oocyte retrieval, by delaying or advancing hCG administration without compromising the outcome.

No MeSH data available.


Related in: MedlinePlus