Low-dose HCG May Improve Pregnancy Rates and Lower OHSS in Antagonist Cycles: a Meta-analysis
Overview
Authors
Affiliations
Human chorionic gonadotrophin (HCG) may substitute FSH to complete follicular growth in IVF cycles. This may be useful in the prevention of ovarian hyperstimulation syndrome. Relevant studies were identified on Medline. To evaluate outcomes, a meta-analysis of low-dose HCG-supplemented IVF cycles versus non-supplemented ones was performed with data from 435 patients undergoing IVF who were administered low-dose HCG in various agonist and antagonist protocols and from 597 conservatively treated patients who served, as control subjects. Using these published data, a decision analysis evaluated four different management strategies. Effectiveness and economic outcomes were assessed by FSH consumption, clinical pregnancy and incremental cost-effectiveness ratios. Clinical pregnancy and ovarian hyperstimulation were the main outcome measures. Nine trials published in 2002-2007 were included. From the prospective studies, in the gonadotrophin-releasing hormone antagonist group, a trend for significance in clinical pregnancy rate was evident (odds ratio [OR], 1.54; 95% confidence interval [CI], 0.98-2.42). Ovarian hyperstimulation was less significant in the antagonist low-dose HCG protocol compared with the non-supplemented agonist protocol (OR 0.30; 95% CI 0.09-0.96). Less FSH was consumed in the low-dose HCG group but this difference was not statistically significant. Low-dose HCG supplementation may improve pregnancy rates in antagonist protocols. Overall, low-dose HCG-supplemented protocols are a cost-effective strategy.
Huong N, Thuy T, Anh P, Long H, Thang L, Ngoc V Int J Med Sci. 2025; 22(4):982-989.
PMID: 39991766 PMC: 11843143. DOI: 10.7150/ijms.106965.
Martins W, Vieira A, Figueiredo J, Nastri C Cochrane Database Syst Rev. 2013; (3):CD010042.
PMID: 23543584 PMC: 11558307. DOI: 10.1002/14651858.CD010042.pub2.
Madani T, Mohammadi Yeganeh L, Khodabakhshi S, Akhoond M, Hasani F J Assist Reprod Genet. 2012; 29(11):1213-20.
PMID: 22956348 PMC: 3510380. DOI: 10.1007/s10815-012-9854-3.
Arce J, Smitz J Gynecol Endocrinol. 2012; 29(1):46-50.
PMID: 22809021 PMC: 3518295. DOI: 10.3109/09513590.2012.705379.
GnRH agonist versus GnRH antagonist in in vitro fertilization and embryo transfer (IVF/ET).
Depalo R, Jayakrishan K, Garruti G, Totaro I, Panzarino M, Giorgino F Reprod Biol Endocrinol. 2012; 10:26.
PMID: 22500852 PMC: 3442989. DOI: 10.1186/1477-7827-10-26.