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Abstract To investigate the effect of GnRH-a (gonadotropin-releasing hormone agonist) and hCG (chorionic gonadotropin) for induction of follicular maturation of infertility women with polycystic ovary syndrome (PCOS). Methods: 116 infertile women with PCOS were selected and were divided into two groups (58 cases in each group) by random number table method. The women in both groups were treated with letrozole for ovulation induction protocol. When the average diameter of the dominant follicle of these women was 18-22 mm, the women in group A were treated with GnRH-a (Group G) for induce follicular maturation, and the women in group B were treated with hCG for induce follicular maturation. The parameters of ovulation induction, ovulation effect, and pregnancy outcomes of the women were compared between the two groups. Results: There were no significant differences in the dominant follicle number, the mature follicle number, the endometrial thickness, and the levels of serum luteinizing hormone (LH), estradiol (E2), and progesterone of the women between the two groups (P＞0.05). Compared with those before GnRH-a or hCG injection, the level of urinary LH of the women in both groups had increased significantly after injection. The level of urinary LH at 4h and 8h after GnRH-a injection of the women in group A was significant higher than that after hCG injection of the women in group B, and the level of urinary LH of the women at 24h after GnRH-a or hCG injection both began to decrease (P＜0.05). The level of urinary LH of the women after hCG injection in group B continued to increase, and which was significant higher than that of the women at 24h and 36h after GnRH-a injection in group A (P＜0.05). There were no significant differences in ovulation rate, pregnancy rate, multiple births rate, and luteal insufficiency rate of the women between the two groups (P＞0.05). The incidences of luteinization (1.7%), the ovarian hyperstimulation syndrome (0%), and the ovarian cyst (6.9%) of the women in group A were all significant lower than those (18.0%, 10.3%, and 22.4%) of the women in group B (P＜0.05). Conclusion: GnRH-a and hCG can effectively induce follicle maturation and ovulation induction, but GnRH-a can effectively prevent the occurrence of ovarian hyperstimulation syndrome and ovarian cysts with better safety, and hCG is cheaper and more economical. So both GnRH-a and hCG have advantages and disadvantages.
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