Efficacy and safety of human chorionic gonadotropin for follicular phase stimulation in assisted reproduction: a systematic review and meta-analysis

The administration of human chorionic gonadotropin in the early and late follicular phase in controlled ovarian stimulation shows results similar to the conventional regimens, with the advantage of decreasing the doses of follicle-stimulating hormone.

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Miguel A. Checa, M.D., Juan José Espinós, M.D., Antonio Requena, M.D.

Vol 97, Issue 6 , Pages 1343-1350.e3



To assess the efficacy and safety of hCG to induce follicular stimulation.


Systematic literature searches of PubMed, EMBASE, CENTRAL, and SciSearch databases. Randomized controlled trials (RCTs) using hCG in early or late follicular phases were included.


Three reproductive medicine services of gynecology in Spain and two universities.


A total of 1,068 women treated in 11 RCTs were included.


Use of hCG versus other hormone treatments, no administration, or placebo during the period of follicular stimulation.

Main Outcome Measure(s):

Live birth, clinical pregnancy, mature oocytes, miscarriage, ovarian hyperstimulation syndrome (OHSS), and FSH doses.


No differences in live birth, miscarriage, and OHSS rates between hCG (given at either the early or late follicular phases) and different control regimens were found. Pooled analysis for clinical pregnancy showed significant differences in favor of hCG at the late follicular phase. The doses of FSH were lower in women treated with hCG at either the early or late follicular phase than in those treated with FSH alone.


The use of hCG in the early and late follicular phase in controlled ovarian stimulation has the advantage of decreasing the doses of FSH.

Read the full text at: http://www.fertstert.org/article/S0015-0282(12)00283-X/fulltext

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.