A prospective comparison of in vitro fertilization (IVF) outcome following controlled ovarian hyperstimulation (COH) regimens using follitropin alpha exclusively or with the addition of low dose human chorionic gonadotropin (hCG) and ganirelix

Purpose: To determine if the addition of luteinizing hormone (LH) activity to a controlled ovarian hyperstimulation regimen for purposes of in vitro fertilization adds any additional benefit to the exclusive use of recombinant (r) FSH in antagonist protocols. Methods: Women with normal endogenous gonadotropin levels were randomly assigned to receive either follitropin alpha exclusively or have the addition of 25 IU human chorionic gonadotropin (hCG) daily. Ganirelix was used when a 14 mm follicle was attained. The data would be analyzed after 70 women were selected for the study and divided into two groups. Results: There were 22 women in each group who proceeded with embryo transfer (some purposely cryopreserved all embryos because of risk of ovarian hyperstimulation syndrome). There were no trends for differences in clinical or delivered pregnancy rates or implantation rates. Conclusions: There does not appear to be any clinical advantage of adding exogenous LH activity to the drug regimen for stimulation of multiple follicles for purposes of in vitro fertilization when using follitropin alpha in an antagonist protocol.