"hCG priming" effect in controlled ovarian stimulation through a long protocol.

Area of Science:

• Reproductive Endocrinology
• Assisted Reproductive Technology (ART)

Background:

• Recombinant luteinizing hormone (rLH) pre-treatment enhances follicle development and embryo yield in GnRH analogue (GnRHa)-down-regulated patients.
• The effect of human chorionic gonadotropin (hCG) priming, a more potent LH/hCG receptor agonist, in controlled ovarian hyperstimulation (COH) using a long GnRH-a protocol is not well-documented.

Purpose of the Study:

• To evaluate the impact of short-term hCG pre-treatment before recombinant FSH (rFSH) administration on follicular development, oocyte quality, and early embryo development in women undergoing ICSI.
• To assess secondary endpoints including endometrial quality and pregnancy rates.

Main Methods:

• A randomized controlled trial involving patients with prior unsuccessful ICSI cycles.
• Patients were assigned to either a standard long GnRH-a protocol with rFSH or the same protocol with a 7-day pre-treatment of 200 IU/day hCG after pituitary desensitization.

Main Results:

• No significant difference in the mean number of oocytes retrieved between groups.
• A trend towards a higher percentage of mature oocytes in the hCG group, though not statistically significant.
• A higher percentage of patients achieving more than one grade 3 embryo and a higher pregnancy rate were observed in the hCG pre-treatment group.

Conclusions:

• Short-term hCG priming in COH via a long GnRH-a protocol appears beneficial.
• This strategy may be particularly advantageous for patients with a history of previous ART failures.
• Findings suggest a positive "hCG priming" effect in specific patient populations undergoing IVF.