Abstract
Background: Influence of pre-retrieval human chorionic gonadotropin (HCG) priming on outcomes of in vitro maturation (IVM) remains controversial. This study aimed to evaluate the effect of HCG priming before oocyte retrieval on clinical outcomes of IVM cycles in patients with polycystic ovarian syndrome (PCOS).Methods: This was a retrospective cohort study analyzing data from the first IVM cycles of unstimulated PCOS patients in a reproductive center of university affiliated hospital from January 2006 to December 2017. Patients received HCG injection before oocyte retrieval were assigned to HCG priming group and those without HCG administration were categorized as none HCG priming (Non-HCG) group. Main outcomes included oocyte maturation rate, number of embryos available, clinical pregnancy rate, and live birth rate. Candidate factors of clinical pregnancy rate was explored by univariate analysis and multivariate logistic regression analysis.Results: There were 324 patients meeting the inclusion and exclusion criteria. Among them, 129 women received HCG priming and 195 other did not. Women in HCG group had significantly lower basal FSH level (5.17 ± 1.63 vs. 5.80 ± 2.38) than Non-HCG group. Both FSH levels were <10 IU/L and the absolute difference was 0.63 IU/L. Other basic characteristics were similar between groups with or without HCG priming. Oocyte maturation rate was trend to be higher in HCG group (52.68 vs. 48.56%) but no statistical significance was found (P = 0.097). No significant difference in clinical pregnancy rate was found between HCG and Non-HCG groups (31.37 vs. 35.67%). Miscarriage rates (31.25 vs. 34.43%) and live birth rates were also similar between groups. HCG priming was not correlated with clinical pregnancy rate in both univariate analysis (P = 0.468) and multivariate logistic regression analysis (P = 0.538; OR = 1.212; 95%CI: 0.657–2.237).Conclusion: HCG priming before oocyte retrieval may not improve clinical outcomes of IVM in patients with PCOS.
Highlights
In vitro maturation (IVM) technology has been clinically used for more than a quarter century since Cha et al [1] reported the first live birth from oocytes matured in vitro in 1991
This study aimed to evaluate the effect of human chorionic gonadotropin (HCG) priming before oocyte retrieval on clinical outcomes of IVM cycles in patients with polycystic ovarian syndrome (PCOS)
Oocyte maturation rate was trend to be higher in HCG group (52.68 vs. 48.56%) but no statistical significance was found (P = 0.097)
Summary
In vitro maturation (IVM) technology has been clinically used for more than a quarter century since Cha et al [1] reported the first live birth from oocytes matured in vitro in 1991. Trounson et al [2] found that immature oocytes retrieved from patients with polycystic ovary syndrome (PCOS) had the potential to become mature in vitro and develop into competent embryos, with which successful live births were resulted. Comparing with traditional ovary-stimulated in vitro fertilization (IVF), IVM has great advantages including lower cost, simpler treatment and decreased risk of complication such as ovarian hyperstimulation syndrome (OHSS). As a recent study reported [8], for IVM cycles of patients with high risk of OHSS, the maturation rate was 62.5% and clinical outcomes of IVM were worse than IVF cycles. This study aimed to evaluate the effect of HCG priming before oocyte retrieval on clinical outcomes of IVM cycles in patients with polycystic ovarian syndrome (PCOS)
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