Low dose HCG : does it work ?
Triggering with a lower dose of hCG and FSH shows promise in IVF treatments, according to a recent study published in Fertility and Sterility. The study aimed to determine if a combination of 1,500 IU of hCG and 450 IU of FSH could be as effective as the standard higher doses of hCG (5,000 or 10,000 IU) in in vitro fertilization (IVF) procedures.

The research included women aged 18–41 undergoing IVF with specific baseline characteristics such as antral follicle count (AFC) of 8 or more, body mass index (BMI) under 30, and no history of more than two canceled IVF cycles due to poor response. The primary measure of success was the total competent proportion, which is the probability of two pronuclei (2PN) per oocyte retrieved, indicating oocyte competence.

The findings from the study are encouraging. Out of 105 women who were randomized, the total competent proportion for the alternative trigger (1,500 IU of hCG + 450 IU of FSH) was 0.59, compared to 0.65 for the standard trigger. The relative risk (RR) was 0.91 with a one-sided 95% confidence interval (CI) of 0.83, indicating non-inferiority as it met the threshold of at least 80% effectiveness. Additionally, there were no differences in live birth rates (LBRs) and no failed retrievals, suggesting that the alternative trigger is a viable option for women undergoing IVF.

This study is important because it suggests that lower doses of hCG and FSH can work just as well as higher doses for maturing oocytes in IVF. This could lower the risk of ovarian hyperstimulation syndrome (OHSS) and other side effects that come with higher hormone doses.

For more details on this study, refer to the publication in Fertility and Sterility, Anaya et al., August 2022 [1].
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