Accumulation of human chorionic gonadotrophin in the serum of patients during in-vitro fertilization treatment cycles with Pergonal

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Abstract
We examined the possible contribution of human chorionic gonadotrophin (HCG) in Pergonal to the serum luteinizing hormone (LH)-like bioactivity in 10 patients (median age32 years, range 28–38) with tubal infertility who were undergoing in-vitro fertilization (IVF), together with 19 controls (median age30 years, range 21–43). IVF patients were treated with clomiphene (50 mg twice daily) over days 2–6 and Pergonal (150 IU i.m.) daily from day 5 until at least day 10. Serum LH was measured by fluoro-immunometric assay (I-LH) and in-vitro Leydig cell bioassay (B-LH). Serum HCG was measured by fluoro-immunometric assay. The data were analysed by paired two-tailed t-test, following logarithmic transformation. From days 1–5, there was an increase in serum B-LH (mean, 95% confidence intervals given in parentheses) from 8.3 (6.8, 10.2) IU/1 to 11.7 (9.8, 13.9) IU/1 [P= 0.004], and in serum I-LH from 4.5 (3.7, 5.4) IU/1 to 5.4 (4.6, 6.3) IU/1 [P= 0.002]. From days 5–8, there was a rise in B-LH to 16.6 (12.6, 21.9) IU/1 [P= 0.023]. The rise in I-LH to 6.3 (5.1, 7.8) IU/1 [P= 0.081] failed to reach significance. Furthermore, serum HCG was ≪0.75 IU/1 until after Pergonal was administered on day 5, then rose to a plateau on day 8 at 1.2(0.8, 1.6) IU/1. Serum HCG in the controls remained ≪0.75 IU/1 throughout. We conclude there is a disproportionate increase in serum B-LH compared to I-LH from days 5–8, corresponding with a rise in serum HCG and the commencement of treatment with Pergonal. The HCG in Pergonal may be contributing to an undesirable rise in serum LH-like bioactivity, which might reduce the success rate of IVF.

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