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- Title
Endocrine effects of h CG supplementation to recombinant FSH throughout controlled ovarian stimulation for IVF: a dose-response study.
- Authors
Thuesen, L. L.; Smitz, J.; Loft, A.; Nyboe Andersen, A.
- Abstract
Objective To analyse the endocrine response in relation to the Δ-4 and Δ-5 pathways of ovarian steroidogenesis after different doses of human chorionic gonadotrophin (h CG) supplementation to recombinant FSH from Day 1 of controlled ovarian stimulation for IVF. Design A randomized dose-response pilot study. Patients A total of 62 IVF patients aged 25-37 years with regular cycles and FSH <12 IU/l were treated with a fixed dose of r FSH 150 IU/day and randomized to four h CG dose groups: Dose 0: 0 IU/day, Dose 50: 50 IU/day, Dose 100: 100 IU/day and Dose 150: 150 IU/day. Results A significant h CG dose-dependent incremental increase was found for progesterone (49-160%), 17-OH-progesterone (223-614%), androstenedione (91-340%) and testosterone (95-338%) from Dose 0 to Dose 150, respectively. Dehydroepiandrosterone ( DHEA) showed minor changes during stimulation and no differences between the groups. The highest oestradiol concentrations were observed in Dose 100 and Dose 150. Sex hormone-binding globulin ( SHBG) increased similarly in all groups at the end of stimulation. No difference was observed for anti-müllerian hormone ( AMH) concentration between the groups, but a 50% decline from the start to the end of the stimulation was found. Conclusion Supplementation with h CG resulted in a clear dose-related response for androgens, progesterone and 17-OH-progesterone. Oestradiol concentration reached maximum levels with an h CG dose of 100 IU/day, suggesting saturation of aromatase function. No difference between the groups was observed for DHEA, supporting that the stimulatory effects of h CG doses on androgens and oestrogen production were mainly induced via the Δ-5 pathway. SHBG, being a biomarker of oestrogen/androgen balance, was not changed by increasing h CG.
- Subjects
FERTILIZATION in vitro; ENDOCRINE glands; CHORIONIC gonadotropins; PROGESTERONE; ANDROSTENEDIONE; SEX hormones; AROMATASE
- Publication
Clinical Endocrinology, 2013, Vol 79, Issue 5, p708
- ISSN
0300-0664
- Publication type
Article
- DOI
10.1111/cen.12186