Twelve Hours Post-Injection Serum Human Chorionic Gonadotropin and Body Mass Index Predicts In Vitro Fertilization Oocyte Maturation Rate: A Cross-Sectional Study

Document Type : Original Article

Authors

1 Reproductive Immunoendocrinology Division, Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia

2 Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia

3 Human Reproduction, Infertility, and Family Planning Cluster, Indonesia Reproductive Medicine Research and Training Center, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia

4 Department of Obstetrics and Gynecology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia

Abstract

Background: In vitro fertilization (IVF) remains a main treatment for infertility cases. Post-injection human chorionic gonadotropin
(hCG) level is an essential factor in determining oocyte maturation rate in IVF. This study aimed to determine the
relationship between 12 hours post-injection serum hCG level and oocyte maturation rate among IVF participants.
Materials and Methods: A cross-sectional study on IVF participants was done at a tertiary hospital in Indonesia from
January 2020 to December 2021. Subjects were injected with 250 μg of recombinant-hCG (r-hCG) subcutaneously.
Twelve hours post-injection serum hCG levels and oocyte maturation rate data were retrieved and analyzed accordingly.
Results: Twenty-eight subjects were recruited into the study. Higher 12 hours post-injection serum hCG was related
to oocyte maturation rate (P=0.046). The cut-off point of 12 hours post-injection serum hCG to predict better oocyte
maturation rate was 90.15 mIU/mL (sensitivity 68.2%, specificity 83.3%). Oocyte maturation rate may be predicted
using body mass index (BMI) and 12 hours post-injection serum hCG.
Conclusion: Higher 12 hours post-injection serum hCG was associated with a higher oocyte maturation rate in IVF
subjects.

Keywords


  1.  

    1. Eskew AM, Jungheim ES. A History of developments to improve in vitro fertilization. Mo Med. 2017; 114(3): 156-159.
    2. European IVF-monitoring Consortium (EIM); European Society of Human Reproduction and Embryology (ESHRE), Calhaz-Jorge C, De Geyter C, Kupka MS, de Mouzon J, et al. Assisted reproductive technology in Europe, 2013: results generated from European registers by ESHRE. Hum Reprod. 2017; 32(10): 1957-1973.
    3. Xia Q, Li Y, Zhang Y, Tian F, Zhang Q, Yao Z. Identification of factors related to fertilization failure in in vitro fertilization-embryo transfer. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2020; 45(8): 960-965.
    4. Franasiak JM, Alecsandru D, Forman EJ, Gemmell LC, Goldberg JM, Llarena N, et al. A review of the pathophysiology of recurrent implantation failure. Fertil Steril. 2021; 116(6): 1436-1448.
    5. Tantitham C, Panunumpa S, Satirapod C. The effect of human chorionic gonadotropin on the in vitro development of immature to mature human oocytes: a randomized controlled study. J Hum Reprod Sci. 2020; 13(2): 133-137.
    6. Gardner DK, Weissman A, Howles CM, Shoham Z. Textbook of assisted reproductive techniques. 5th Boca Raton, FL: CRC Press; 2018; 96-121.
    7. Nora H, Wiweko B, Muharam R, Rajuddin, Wangge G, Hestiantoro A, et al. Impact of serum human chorionic gonadotropin and luteinizing hormone receptor expression to oocyte maturation rate: a study of controlled ovarian stimulation. J Hum Reprod Sci. 2020; 13(1): 46-50.
    8. Braga DPAF, Zanetti BF, Setti AS, Iaconelli A Jr, Borges E Jr. Immature oocyte incidence: contributing factors and effects on mature sibling oocytes in intracytoplasmic sperm injection cycles. JBRA Assist Reprod. 2020; 24(1): 70-76.
    9. Abbara A, Clarke SA, Dhillo WS. Novel concepts for inducing final oocyte maturation in in vitro fertilization treatment. Endocr Rev. 2018; 39(5): 593-628.
    10. Drakakis P, Loutradis D, Beloukas A, Sypsa V, Anastasiadou V, Kalofolias G, et al. Early hCG addition to rFSH for ovarian stimulation in IVF provides better results and the cDNA copies of the hCG receptor may be an indicator of successful stimulation. Reprod Biol Endocrinol. 2009; 7: 110.
    11. Theofanakis C, Drakakis P, Besharat A, Loutradis D. Human chorionic gonadotropin: the pregnancy hormone and more. Int J Mol Sci. 2017;18(5): 1059.
    12. Pakhomov SP, Orlova VS, Verzilina IN, Sukhih NV, Nagorniy AV, Matrosova AV. Risk factors and methods for predicting ovarian hyperstimulation syndrome (OHSS) in the in vitro fertilization. Arch Razi Inst. 2021; 76(5): 1461-1468.
    13. Gunnala V, Melnick A, Irani M, Reichman D, Schattman G, Davis O, et al. Sliding scale HCG trigger yields equivalent pregnancy outcomes and reduces ovarian hyperstimulation syndrome: analysis of 10,427 IVF-ICSI cycles. PLoS One. 2017; 12(4): e0176019.
    14. Zhang L, Wang H, Zhang R, Liang J, Liu C, Zhou Y, et al. Correlation of follicular fluid human chorionic gonadotrophin level with oocyte maturity and early embryonic development. Nan Fang Yi Ke Da Xue Xue Bao. 2014; 34(2): 260-264.
    15. Lin Y, Yang P, Chen Y, Zhu J, Zhang X, Ma C. Factors inducing decreased oocyte maturation rate: a retrospective analysis of 20,939 ICSI cycles. Arch Gynecol Obstet. 2019; 299(2): 559-564.
    16. Blumenfeld Z. The ovarian hyperstimulation syndrome. Vitam Horm. 2018; 107: 423-451.