Combined administration of gonadotropin-releasing hormone agonist with human chorionic gonadotropin for final oocyte maturation in GnRH antagonist cycles for in vitro fertilization.

OBJECTIVE: To evaluate the effects of combined administration of gonadotropin-releasing hormone (GnRH) agonist with human chorionic gonadotropin (hCG)for final oocyte maturation in GnRH antagonist cycles for in vitro fertilization (IVF).

STUDY DESIGN: A total of 120 infertile women undergoing GnRH antagonist multiple-dose protocol for controlled ovarian stimulation were recruited and randomized into 2 groups: a study group (n=60) and a control group (n=60). For the study group, both GnRH agonist and recombinant hCG (rhCG) were injected concomitantly for final oocyte maturation when 1 or more follicles reached a mean diameter of 18 mm. For the control group, rhCG alone was administered for final oocyte maturation.

RESULTS: There were no significant differences in patient characteristics. The 2 groups were also similar with respect to the number of oocytes retrieved, fertilized oocytes and good-quality embryos. Embryo implantation rate (24.7% vs. 14.9%), clinical pregnancy rate per cycle (53.3% vs. 33.3%), and live birth rate (50.0% vs. 30.0%) were significantly higher in the study group than in the control group (p = 0.006, p = 0.027, and p = 0.025, respectively).

CONCLUSION: Combined administration of GnRH agonist with rhCG may be beneficial in improving endometrial receptivity and pregnancy rate in GnRH antagonist cycles for IVF.