P-228: Low Dose HCG Adjunct to r-hFSH/GnRH Antagonist for Controlled Ovarian Stimulation in Assisted Reproductive Technology: A Prospective and Randomized Trial

Background: Deep suppression of LH in GnRH antagonist cycles may have detrimental effect on reproductive out come. It was hypnotized that adding LH activity via the administration of low dose HCG in late follicular phase shortened the duration of stimulation, decreased consumption of gonadotropin and increased estrogen levels. This study was designed to evaluate the effect of adding low dose HCG in GnRH antagonist / r-hFSH protocol on the outcome of assisted reproductive technology in the patients undergoing IVF/ICSI cycles. Materials and Methods: This study was a prospective, randomized clinical trial conducted in Tehran University of medical Sciences. One hundred and twenty patients aged 21-39 years with an indication for IVF/ICSI were recruited. All patients received r-hFSH, when leading follicle reached 13-14 mm, a daily dose of cetrorelix (0.25 mg) was initiated. In addition, a daily injection of low dose HCG 200 IU was begun in a random fashion. The study was approved by the ethics committee of Teheran University of Medical Sciences. Results: There was no difference in the number of retrieved oocytes, mature oocytes, endometrial thickness, fertilization rate, top quality embryo and total number of embryo between the two groups. Low dose HCG did not decrease the duration of treatment (11.88 ± 1.40) days in the study group vs (12.19 ± 1.31 day) in the control group, but significantly increase peak E2 (2565.40 ± 1758.60 pg/ml) in the study group vs (1788.35 ± 1298.02 pg/ml) in the control group. Although not significant, it was observed lower pregnancy rate in low HCG group (25% vs. 30%). Conclusion: Our finding showed adding low dose HCG to GnRH antagonist in IVF/ICSI does not have positive effect on the outcome of the cycle.