Effect Of Serum HCG Levels 12-13 Hours After Trigger On The Outcome In IVF/ICSI Cycles

Objective: To investigate the effect of different serum hCG levels 12-13 hours after trigger and supplemented hCG on the treatment outcome in IVF/ICSI cycles.Measures: There was a retrospective study with 741 patientsin 752 cycles(555 IVF cycles and 197 ICSI cycles)in the Fourth Hospital of Hebei Medical University Department of Reproductive Medicine from July 2015 to July 2017.The patients were divided into group A,B and C according to the serum hCG level 12-13 hours after trigger by quartile method.The patients whose serum hCG levels lower than 80 IU/L were assigned to group A,and group A was further divided into group A1(hCG<80IU/L,no supplementation with hCG)and group A2(hCG<80IU/L,supplemented with hCG 15-16 hours after trigger),whose hCG levels ranged from 80 IU/L to 110 IU/L were assigned to group B,whose hCG levels higher than 110 IU/L were assigned to group C.The outcomes were compared with oocyte retrieval rate,MII oocyte rate,fertilization rate,high quality embryo rate,cleavage rate,severe OHSS rate,implantation rate,clinical pregnancy rate and live birth rate in the four groups,and the correlation between serum hCG and BMI,oocyte retrieval rate,MII oocyte rate,fertilization rate were analysed.Results: In the IVF/ICSI cycles,the BMI of group A were higher than that of group B and C,and that of group B was higher than that of group C(P<0.05).There was negative correlation between serum hCG level and BMI in patients(P<0.05).The oocyte retrieval rate of group A1 was lower than that of group A2,B and C(P<0.05).There was positive correlation between serum hCG level and oocyte retrieval rate in group A1,B and C(P<0.05).There were no significant differences in high quality embryo rate,cleavage rate,severe OHSS rate,implantation rate,clinical pregnancy rate and live birth rate in the four groups(P>0.05).In the IVF cycles,the fertilization rate of group A1 was lower than that of group B and C,and that of group A2 was higher than that of group A1,B and C(P<0.05).There was no correlation between serum hCG level and fertilization rate in group A1,B and C(P>0.05).In the ICSI cycles,the MII oocyte rate of group A1 was lower than that of group C(P<0.05).There was positive correlation between serum hCG level and MII oocyte rate in group A1,B and C(P<0.05).The fertilization rate of group A1 was lower than that of group A2 and C(P<0.05),and there were no significant differences of fertilization rate between group A1 and B,either among group A2,B and C.There was no significant correlation between serum hCG level and fertilization rate in group A1,B and C(P>0.05).Conclusion:1.In IVF/ICSI cycle,the higher BMI the patients had,the lower serum hCG level obtained 12-13 hours after trigger.2.When the serum hCG level 12-13 hours after trigger in IVF/ICSI cycle was lower than 80 IU/L,it affected oocyte retrieval rate,MII oocyte rate and fertilization rate.3.For patients with serum hCG below 80 IU/L 12-13 hours after trigger,supplementation with hCG at 15-16 hours could improve the oocyte retrieval rate and fertilization rate without increasing the risk of severe OHSS simultaneously.