Human Chorionic Gonadotrophin Priming Before Immature Oocyte Retrieval From Unstimulated Women With Polycystic Ovarian Syndrome: A Systematic Review

OBJECTIVE:To access the clinical efficacy and safety of human chorionic gonadotrophin priming before immature oocyte retrieval from unstimulated women witch Polycystic ovarian syndrome (PCOS).METHODS:We searched The Cochrane Central Register of Controlled Trials(CENTRAL),PubMed,EMbase,CBMdisc,CNKI,VIP,WANFANG DATABASE and web site of some clinical trials such as Clinical trials,Current controlled trials,PhRMA Clinical Study Results Database.Relevant journals were also hand searched to April 2010.We collected randomizedcontrolled trials (RCT) comparing human chorionic gonadotrophin priming before immature oocyte retrieval from unstimulated women witch Polycystic ovarian syndrome (PCOS).Study selection and quality assessment, data extraction and analyses were undertaken by two reviewers independently according to the Cochrane Handbook for Systematic Reviews of interventions.Meta-analyses were also performed.RESULTS:Two RCTs involving 72 eligible patients were included, a total of 642 oocytes were retrieved.Two trials(49 patients) compared 10000 IU human chorionic gonadotrophin priming before immature oocyte retrieval with non-HCG-primed group from unstimulated women in Polycystic ovarian syndrome.One trials(23 patients)compared priming 10,000 IU with 20,000 IU of human chorionic gonadotropin in women in polycystic ovary syndrome who are undergoing in vitro maturation.The Meta-analyses showed that there were no significiant differences in the number of oocytes between the HCG-primed group and the non-HCG-primed group [SMD=0.83,95%CI(-7.76,4.2),P=0.56].There were no significant differences in the rates of oocyte fertilization and cleavage in these two groups.There is difference in dispute in the maturation rate, and clinical pregnancy rate.There were no differences in the mean number of immature oocytes retrieved and oocyte maturation rates in the 20,000-IU group. the study also showed a lower fertilization rate in the 20,000-IU-hCG group。All PCOS patients had no ovarian hyperstimulation syndrome.CONCLUSION:The results of this study suggests that hCG priming before oocyte aspiration does not improve outcome.Due to the difference of HCG dosage,more well-designed multi-center randmozied controlled trials should be performed to confirm the drug dosage,courses and the time of HCG injected...