Clin Exp Reprod Med.  2013 Jun;40(2):90-94. 10.5653/cerm.2013.40.2.90.

The effectiveness of earlier oocyte retrieval in the case of a premature luteinizing hormone surge on hCG day in in vitro fertilization-embryo transfer cycles

• Choi MH
• Cha SH
• Park CW
• Kim JY
• Yang KM
• Song IO
• Koong MK
• Kang IS
• Kim HO

• KMID: 1493215
• DOI: http://doi.org/10.5653/cerm.2013.40.2.90

Abstract

OBJECTIVE
To evaluate the efficacy of earlier oocyte retrieval in IVF patients with a premature LH surge on hCG day.
METHODS
One hundred forty IVF patients (164 cycles) with premature LH surge on hCG day were included, retrospectively. We divided them into 2 study groups: LH surge with timed ovum pick-up (OPU) 36 hours after hCG injection (group B, 129 premature cycles), and LH surge with earlier OPU within 36 hours after hCG injection (group C, 35 cycles). Control groups were tubal factor infertility without premature LH surge (group A, 143 cycles).
RESULTS
The mean age (year) was statistically higher in group C than in groups A or B (38.2+/-5.4 vs. 36.2+/-4.2 vs. 36.8+/-4.9, respectively; p=0.012). The serum LH levels (mIU/mL) on hCG day were significantly higher in group B and C than in group A (22.7+/-14.9 vs. 30.3+/-15.9 vs. 3.2+/-2.9, respectively; p>0.001). Among groups A, B, and C, 4.9%, 31.7%, and 51.4% of the cycles, respectively, had no oocytes, and the overall rates of cycle cancellation (OPU cancellation, no oocyte, or no embryos transferrable) were 15.4%, 65.9%, and 74.3%, respectively. The fertilization rate (%) was significantly higher in group B than in group C (73.2+/-38.9 vs. 47.8+/-42.9, p=0.024). The clinical pregnancy rate was significantly higher in group C than in groups A and B (44.4% vs. 27.3% vs. 9.1%, respectively, p=0.021). However, the miscarriage rate was also higher in group C than in group B (22% vs. 0%, respectively, p=0.026).
CONCLUSION
Earlier OPU may not be effective in reducing the risk of cycle cancellation in patients with premature LH surge on hCG day. A larger scale study will be required to reveal the effectiveness of earlier ovum retrieval with premature LH surge.

Keyword

Premature luteinization; Luteinizing hormone; Oocyte retrieval; Fertilization in vitro

MeSH Terms

Abortion, Spontaneous
Embryonic Structures
Female
Fertilization
Fertilization in Vitro
Humans
Infertility
Lutein
Luteinizing Hormone
Oocyte Retrieval
Oocytes
Ovum
Pregnancy
Pregnancy Rate
Retrospective Studies
Lutein
Luteinizing Hormone