Comparison of serum progesterone levels and incidence of pregnancy with urinary and recombinant HCG in women undergoing ICSI

Abstract

Mohamed Mosaad, Hesham M. Shaban, Gamil M. Abd-Allah, Gaber A. Rezk

Objective: Luteinizing hormone (LH) surge is important in the final maturation of the oocyte and in oocyte retrieval. The structural similarity of human chorionic gonadotropin (HCG) and LH allows its binding to HCG/LH receptor. So, we aimed to compare the efficacy of urinary HCG (uHCG) and recombinant HCG (rHCG) for induction of oocyte maturation, triggering ovulation, and incidence of pregnancy through assessing the serum levels of estradiol (E2), progesterone (P), and β-subunit HCG (βHCG) in infertile women undergoing intracytoplasmic sperm injection (ICSI) cycles. Subjects and Methods: Eighty-one Egyptian females were recruited in this study including 71 infertile females undergoing ICSI and 10 apparently healthy females as a control group. The infertile female patients were classified based on the treatment used for triggering of mature follicles into two groups: 35 infertile females who had received 10000 International Units (IU) uHCG and 36 infertile females who had received 500 µg rHCG. Serum levels of basal follicle stimulating hormone (FSH) and LH, estradiol (E2), P, and βHCG were measured at different times of menstrual cycle by enzyme-linked immunosorbent assay methods. Results: Serum FSH and LH were similar in all the studied groups. Serum P level at day 5 embryo transfer (ET) and the number of retrieved and mature oocytes were comparable in the rHCG and uHCG groups while serum P level at the day of oocyte pick up was significantly higher in the rHCG group than in the uHCG group. The successful pregnancy was higher in the uHCG group than in the rHCG group. Conclusion: The uHCG showed more effective biochemical pregnancy rate than the rHCG. However, rHCG showed equivalent efficacy to uHCG in terms of serum P level at day 5 of ET, the number of retrieved oocytes and mature oocytes in female patients undergoing ICSI. On the other hand, rHCG increases the serum P level at the day of oocyte pick up to abnormally high level, which may reduce the incidence of pregnancy in females received rHCG.