İntrastoplazmik Sperm İnjeksiyonu (Icsı) Yapılan Fazla Kilolu ve Obez Hastalarda 250 Μg ve 500 Μg Rekombinant İnsan Koryonik Gonadotropin (R-Hcg)' in Karşılaştırılması

Abstract

There is paucity of data in the literature about the impact of recombinant-human chorionic gonadotropin (r-hCG) dose; 250 μg or 500 μg, on in vitro fertilization (IVF)/intra cytoplasmic sperm injection (ICSI) outcomes in overweight and obese patients. By far our aim is to investigate the effect of r-hCG dose; 250 μg or 500 μg, on ICSI outcomes in overweight and obese patients. Fifty-eight consecutive infertile patients (76 cycles) with body mass index (BMI) ≥25 kg/m2 who underwent ICSI at our center were enrolled. We included patients >20, ≤38 years of age and who has BMI ≥25 kg/m2, without polycystic ovarian syndrome (PCOS) and poor ovarian reserve. We used only fresh cycles. We stratified these cycles into two groups according to the method we used to trigger ovulation. Group I was constituted of 16 patients (21 cycles) who get 250 μg subcutan (s.c.) r-hCG for oocyte triggering whereas Group II was constituted of 42 patients (55 cycles) who get 500 μg s.c. r-hCG for oocyte triggering. The numbers of retrieved oocyte-cumulus complexes (11.8±6.8 vs 11.6±6.7), metaphase II oocytes (9.1±5.0 vs 9.6±5.5), two pronucleated (2PN) oocytes (7.1±4.1 vs 7.7±4.6) and the number of embryos transferred (1.5± 0.5 vs 1.3±0.4) were similar between groups. Of interest, Germinal vesicle (GV) oocytes/oocyte-cumulus complexes ratio (14.6%vs 8.9%), rate of arrested embryos (18.0%vs 7.5%) and rate of embryos with multinucleation (14.2%vs 7.2%) were significantly higher in Group I when compared to Group II. The metaphase II oocytes/oocyte-cumulus complexes ratio (76.9%vs 82.9%), the rate of embryos with ≥7 blastomeres on day 3 (61.4 %vs 79.4%) and rate of blastocyst transfer (11.8%vs 51.8%) were higher in Group II when compared to Group I. Rates of implantation (12.9%vs 32.4%) and clinical pregnancy per embryo transfer (19.0% vs 41.8%, P=0.06) were lower in Group I. In conclusion, we noted that 500 μg r-hCG for oocyte triggering in ICSI cycles produced better oocytes and embryos and consecutively better pregnancy rates in overweight and obese patients when compared to 250 μg r-hCG.