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Clinical outcomes of assisted reproductive technology treatment by using a self‐injection of recombinant human chorionic gonadotropin as the final maturation trigger
Authors:Koji Nakagawa  Midori Oba  Kaori Ehara  Nozomi Ishigaki  Nao Ino  Akiko Itakura  Ryo Tsutsumi  Katsuki Nakao  Yuko Ojiro  Rikikazu Sugiyama
Institution:Division of Reproductive Medicine, Sugiyama Clinic, Tokyo, Japan
Abstract:

Purpose

To evaluate the efficacy and safety of self‐injections of the prefilled recombinant human chorionic gonadotropin (r‐hCG) in a syringe in assisted reproductive technology (ART) treatment for the maturation trigger (MT), as compared to self‐injections of conventional hCG and intranasal administration of gonadotropin‐releasing hormone agonist (GnRH‐a).

Methods

Between January and April, 2017, 396 patients who underwent oocyte retrieval were recruited. Of these, 396 patients were classified into three groups, according to the types of MT: (1) the urinary human chorionic gonadotropin (u‐hCG) group that consisted of patients who had a self‐injection of u‐hCG (n = 127); (2) the GnRH‐a group that received nasal administration of GnRH‐a (n = 159); and (3) the r‐hCG group that had a self‐injection of r‐hCG (n = 110). Several ART outcomes were evaluated.

Results

The mature oocyte retrieval rate was not different between the u‐hCG, r‐hCG, and GnRH‐a groups and the fertilization and cleavage rates were similar between the three groups. The clinical pregnancy rates did not significantly differ between the GnRH‐a group and the u‐hCG group; however, it was significantly lower in the GnRH‐a group, compared to the r‐hCG group. No difference was observed in the incidence of moderate or more severe ovarian hyperstimulation syndrome among the three groups.

Conclusion

The self‐injection of the prefilled r‐hCG is a favorable MT for ART patients.
Keywords:gonadotropin‐releasing hormone analog  maturation trigger  ovarian hyperstimulation syndrome  recombinant human chorionic gonadotrophin  urinary human chorionic gonadotropin
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