Abstract
Objective: Stimulation protocols often utilize oral contraceptive pre-treatment prior to initiation of GnRH agonists or antagonists to facilitate scheduling of the IVF cycle. In some cases, this leads to profound suppression of endogenous gonadotropins. Prior investigation has demonstrated that initiation of FSH prior to resolution of this suppression is associated with delayed follicular growth and increased consumption of gonadotropins. It has been proposed that LH deficiency is responsible for this delayed response. Many IVF programs currently employ ’mixed’ stimulation protocols using HMG together with FSH preparations in attempt to overcome this problem. Despite this approach, some patients may continue to have a suboptimal response. This is likely due to the short half-life of the LH component of hMG preparations. Recombinant HCG has recently become available. This drug may serve as a source of LH activity with a significantly longer half life and duration of action than the LH component of HMG. This study was undertaken to evaluate the potential benefit of using a daily low dose of recombinant hCG as an adjunct to recombinant FSH treatment for ovulation induction in IVF patients.
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