Abstract：
OBJECTIVE: Does splitting the human chorionic gonadotrophin (HCG) support in IVF cycles triggered by a gonadotrophin-releasing hormone agonist result in a better progesterone profile?
METHODS: Randomized controlled three-arm study, performed at the Fertility Clinic, Odense University Hospital, Denmark. Patients with 12-25 follicles ≥12 mm were randomized into three groups: Group 1 - ovulation triggered with 6500 IU HCG; Group 2 - ovulation triggered with 0.5 mg GnRH agonist, followed by 1500 IU HCG on the day of oocyte retrieval (OCR); and Group 3 - ovulation triggered with 0.5 mg GnRH agonist, followed by 1000 IU HCG on the day of OCR and 500 IU HCG on OCR + 5. All groups received 180 mg vaginal progesterone. Progesterone concentrations were analysed in eight blood samples from each patient.
RESULTS: Sixty-nine patients completed the study. Baseline and laboratory data were comparable. Progesterone concentration peaked on OCR + 4 in Groups 1 and 2, and peaked on OCR + 6 in Group 3. On OCR + 6, the progesterone concentration in Group 2 was significantly lower compared with Groups 1 and 3 (P = 0.003 and P < 0.001, respectively). On OCR + 8, the progesterone concentration in Group 3 was significantly higher compared with the other groups (both P<0.001). Progesterone concentrations were significantly higher in Group 3 from OCR + 6 until OCR + 14 compared with the other groups (all P ≤ 0.003). Four patients developed ovarian hyperstimulation syndrome in Group 3.
CONCLUSIONS: Sequential HCG support after a GnRH agonist trigger provides a better progesterone concentration in the luteal phase.
METHODS: Randomized controlled three-arm study, performed at the Fertility Clinic, Odense University Hospital, Denmark. Patients with 12-25 follicles ≥12 mm were randomized into three groups: Group 1 - ovulation triggered with 6500 IU HCG; Group 2 - ovulation triggered with 0.5 mg GnRH agonist, followed by 1500 IU HCG on the day of oocyte retrieval (OCR); and Group 3 - ovulation triggered with 0.5 mg GnRH agonist, followed by 1000 IU HCG on the day of OCR and 500 IU HCG on OCR + 5. All groups received 180 mg vaginal progesterone. Progesterone concentrations were analysed in eight blood samples from each patient.
RESULTS: Sixty-nine patients completed the study. Baseline and laboratory data were comparable. Progesterone concentration peaked on OCR + 4 in Groups 1 and 2, and peaked on OCR + 6 in Group 3. On OCR + 6, the progesterone concentration in Group 2 was significantly lower compared with Groups 1 and 3 (P = 0.003 and P < 0.001, respectively). On OCR + 8, the progesterone concentration in Group 3 was significantly higher compared with the other groups (both P<0.001). Progesterone concentrations were significantly higher in Group 3 from OCR + 6 until OCR + 14 compared with the other groups (all P ≤ 0.003). Four patients developed ovarian hyperstimulation syndrome in Group 3.
CONCLUSIONS: Sequential HCG support after a GnRH agonist trigger provides a better progesterone concentration in the luteal phase.
摘要：
目的：促性腺激素释放激素激动剂引发的IVF周期中人绒毛膜促性腺激素（HCG）支持分裂是否会导致更好的孕酮谱？
方法：随机对照三臂研究，在生育诊所进行的，欧登塞大学医院,丹麦。12-25个卵泡≥12毫米的患者被随机分为三组：第1组-用6500IUHCG触发排卵；第2组-用0.5mgGnRH激动剂触发排卵，然后在取卵日（OCR）为1500IUHCG；第3组-用0.5mgGnRH激动剂触发排卵，随后在OCR当天为1000IUHCG，在OCR+5上为500IUHCG。所有组接受180mg阴道孕酮。在来自每个患者的八个血液样品中分析孕酮浓度。
结果：69名患者完成了研究。基线和实验室数据具有可比性。孕酮浓度在组1和2中在OCR+4上达到峰值,并且在组3中在OCR+6上达到峰值。在OCR+6时,第2组的孕酮浓度显著低于第1组和第3组(P=0.003和P<0.001)。在OCR+8时，第3组的孕酮浓度明显高于其他组（均P<0.001）。从OCR+6到OCR+14，第3组的孕酮浓度明显高于其他组（P均≤0.003）。第3组中有4例患者出现卵巢过度刺激综合征。
结论：GnRH激动剂触发后的顺序HCG支持在黄体期提供了更好的孕酮浓度。
方法：随机对照三臂研究，在生育诊所进行的，欧登塞大学医院,丹麦。12-25个卵泡≥12毫米的患者被随机分为三组：第1组-用6500IUHCG触发排卵；第2组-用0.5mgGnRH激动剂触发排卵，然后在取卵日（OCR）为1500IUHCG；第3组-用0.5mgGnRH激动剂触发排卵，随后在OCR当天为1000IUHCG，在OCR+5上为500IUHCG。所有组接受180mg阴道孕酮。在来自每个患者的八个血液样品中分析孕酮浓度。
结果：69名患者完成了研究。基线和实验室数据具有可比性。孕酮浓度在组1和2中在OCR+4上达到峰值,并且在组3中在OCR+6上达到峰值。在OCR+6时,第2组的孕酮浓度显著低于第1组和第3组(P=0.003和P<0.001)。在OCR+8时，第3组的孕酮浓度明显高于其他组（均P<0.001）。从OCR+6到OCR+14，第3组的孕酮浓度明显高于其他组（P均≤0.003）。第3组中有4例患者出现卵巢过度刺激综合征。
结论：GnRH激动剂触发后的顺序HCG支持在黄体期提供了更好的孕酮浓度。
