Does the HCG trigger dose used for IVF impact luteal progesterone concentrations? a randomized controlled trial

Area of Science:

• Reproductive Endocrinology
• In Vitro Fertilization (IVF)

Background:

• Luteal-phase support (LPS) is crucial in IVF cycles.
• Endogenous progesterone production is vital for successful implantation.
• The impact of ovulation trigger dose on luteal progesterone requires further investigation.

Purpose of the Study:

• To investigate the association between the ovulation trigger dose of human chorionic gonadotrophin (HCG) and endogenous progesterone production during the luteal phase.
• To determine if varying HCG trigger doses influence progesterone levels in women undergoing GnRH antagonist IVF treatment.

Main Methods:

• A randomized controlled four-arm study involving women undergoing GnRH antagonist IVF.
• Participants were triggered with different doses of HCG (5000 IU, 6500 IU, 10,000 IU) or received standard care.
• Eight blood samples were collected during the luteal phase to measure progesterone levels.

Main Results:

• A significant positive association was found between HCG trigger dose and progesterone levels at 8, 10, and 14 days post-oocyte retrieval.
• Higher HCG trigger doses led to significantly different progesterone concentrations compared to lower doses.
• Increased HCG trigger dose was correlated with increased progesterone production from individual follicles.

Conclusions:

• Increasing HCG trigger doses significantly enhances endogenous progesterone concentration during the mid-late luteal phase.
• The findings suggest that HCG trigger dose is a determinant of luteal phase progesterone levels in IVF.
• Optimizing HCG dosage may be a strategy to improve luteal phase adequacy in assisted reproduction.