Effects of HMG supplementation in the middle and late follicle phases on the outcome of in vitro fertilization-embryo transfer

Objective To explore the effects of human menopausal gonadotropopin(HMG)supplementation on the outcome of women underwent in vitro fertilization-embryo transfer(IVF-ET).Methods The data of 406IVF-ET cycles in Reproductive Medicine Center of the 105th Hospital of PLA were analyzed retrospectively.All cases underwent long down regulation protocol with gonadotropin releasing hormone agonist(GnRH-a)in the mid-luteal phase and controlled ovarian stimulation(COS)was carried out with follicle stimulation hormone(r-FSH)on the days 3-5of the menstrual cycle.Then 75-150U HMG was administrated in group A(257cycles)when a dominant follicle reached a diameter of 14mm,while the remaining cases(149cycles)underwent HCG still with r-FSH were served as group B.Based on the LH levels on the day of HMG administration,the cases in group A were subdivided into:group A1(99cycles),LH1U/L;group A2(96cycles),1U/L≤LH≤2U/L,and group A3(62cycles),LH2U/ L.Clinical outcomes of all groups were analyzed and compared.Results The durations and doses of gonadotropin(Gn),the rates of fertilization and pregnancy were higher and the abortion rate was lower in group A than that in group B(P0.05).There were no significant difference in serum LH concentrations on the days of HMG and HCG administration,oocytes retrieved,the rates of cleavage and embryo implantation between group A and group B(P0.05).There was significant difference in serum LH levels on the day of HMG supplementation among group A1,A2and A3(P0.05)and the doses of HMG supplemented reduced gradually from group A1to group A3(P0.05).The duration of Gn was significantly lower and the fertilization rate was significantly higher in group A3compared with group A1and A2(P0.05).The pregnancy rate in group A2and A3was higher than that in group A1,which showed significant difference between group A2and A1(P0.05).Meanwhile,there were no significant difference in doses of r-FSH,serum LH concentrations on the day of HCG administration,oocytes retrieved,the rates of cleavage,implantation and abortion among the three groups(P0.05).Conclusion HMG supplementation in the middle and late follicle phases in standard long down-regulation protocol during IVF could obtain higher pregnancy rate and lower abortion rate,especially when their serum LH level was between 1U/L and 2U/L without obvious increase of LH.