A prospective, randomized, controlled, double-blind, double-dummy comparison of recombinant and urinary HCG for inducing oocyte maturation and follicular luteinization in ovarian stimulation

Abstract
A randomized, controlled, double-blind, double-dummy, phase III clinical trial was conducted in 84 women to compare the efficacy of a s.c. injection of 250 μg recombinant human chorionic gonadotrophin (rHCG; Ovidrel®) to an i.m. injection of 5000 IU urinary HCG (uHCG; Profasi®) in inducing folliculogenesis, resumption of oocyte meiosis and luteinization after ovulation induction with recombinant follicle stimulating hormone (Gonal-F®). The study primary endpoint was comparison of the number of oocytes retrieved per patient receiving either compound. Secondary comparisons included the number of oocytes retrieved per follicles aspirated; the number of mature oocytes; normally fertilized oocytes; and cleaved embryos. There were no statistically significant differences between groups for the primary endpoint (mean ± SD oocytes retrieved 10.8 ± 4.5 for rHCG versus 10.3 ± 5.1 for uHCG) or each of the secondary endpoints except for increased concentrations of progesterone 6–7 days after rHCG administration (353.2 ± 215.1 versus 234.1 ± 129.4 nmol/l; P < 0.004) and for HCG during the luteal phase following rHCG (P < 0.02). There were also no significant side-effects for either drug. Since the confidence intervals for the difference of the number of oocytes retrieved between the two treatment groups were within the bounds defined by the multi-trial protocol equivalence between rHCG and uHCG could be declared.