In a nutshell
This study investigated the effect of low dose human chorionic gonadotrophin (hCG) in women with polycystic ovarian syndrome (PCOS).
They found that hCG may improve the number of follicles and clinical pregnancy rates (CPR) in women with PCOS.
Some background
Polycystic ovarian syndrome (PCOS) is a common condition that can cause fertility problems. Women with PCOS may not ovulate normally. In order to become pregnant ovulation must be stimulated using drugs. This is called controlled ovarian stimulation (COS). This can be done using synthetic hormones. These included follicle-stimulating hormone (FSH) and luteinizing hormone (LH). One complication of COS is ovarian hyperstimulation syndrome (OHSS). OHSS has a number of side effects. One is the development of multiple small follicles. These small follicles are less likely to become viable embryos. Large preovulatory follicles (POFs) are preferred for assisted reproduction (AR).
Human chorionic gonadotropin (hCG) is another drug that can be used. hCG may stimulate the growth of fewer follicles that are larger. This reduces the risk of OHSS in PCOS patients. hCG must be given early in the development of follicles to achieve this. No studies have investigated hCG treatment in early follicular development. It is unclear if hCG improves fertility outcomes in women with PCOS.
Methods & findings
This study included 40 women with PCOS. Women were undergoing their first in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycle. All patients received human menopausal hormone (hMH) and progesterone. HMG is a hormone derived from hCG. Progesterone is a female hormone that helps the implantation and growth of the embryo. Half of women were also given low dose hCG (LD-hCG). The main outcome was the number of large POFs. Other fertility outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR).
The number of large POFs was higher in LD-hCG-treated patients. CPR was slightly higher in LD-hCG patients (17.75 vs 13.2). The number of oocytes (eggs) retrieved and good quality embryos were similar between groups.
CPR was slightly higher for the hCG group (62.52%) compared to the control group (41.94%). LBRs were also slightly higher in the hCG group (48.28% vs 35.48%). None of the women in either group experienced severe OHSS.
The bottom line
The authors concluded that adding hCG during COS may improve CPR in women with PCOS.
The fine print
The number of patients in this study was low. Also, the differences between groups were not statistically significant. Larger studies are needed to investigate the effects of LD-hCG in women with PCOS.
What’s next?
If you have any concerns regarding infertility please consult with your physician.
Published By :
Frontiers in Endocrinology
Date :
Jan 11, 2020
