GnRH-agonist ovulation trigger in patients undergoing controlled ovarian hyperstimulation for IVF with ultrashort flare GnRH-agonist combined with multidose GnRH-antagonist protocol

Gynecol Endocrinol. 2013 Jan;29(1):51-3. doi: 10.3109/09513590.2012.705376. Epub 2012 Aug 3.

Abstract

Objective: To evaluate, whether Gonadotropin-releasing hormone-agonist (GnRH-agonist or GnRH-ag) trigger in patients undergoing the ultrashort GnRH-ag/GnRH-antagonist (GnRH-ant) protocol is as effective as in patients at high risk to develop severe ovarian hyperstimulation syndrome (OHSS), who undergo the multidose GnRH-ant protocol.

Design: Cohort study.

Setting: University hospital.

Patients: All consecutive women aged ≤35 years admitted to our IVF unit from January 2011 to October 2011 who reached the ovum pick-up stage.

Interventions: Triggering final oocytes maturation by GnRH-ag instead of hCG, in high-responder patients undergoing either the ultrashort GnRH-ag/GnRH-ant or the multidose GnRH-antagonist controlled ovarian hyperstimulation (COH) protocols.

Main outcome measures: Ovarian stimulation characteristics, percentage of mature oocytes, fertilization and pregnancy rates.

Results: No inbetween groups differences were observed in ovarian-stimulation related variable, percentage of mature oocytes, fertilization or pregnancy rates. No case of moderate-severe OHSS was reported in the study, or the control groups.

Conclusions: Three consecutive doses of daily GnRH-ag administration at the beginning of ultrashort flare GnRH-ag/GnRH-ant COH protocol, did not interfere with the ability of the GnRH-ag to trigger final oocytes maturation at the end of the COH cycle.

MeSH terms

  • Adult
  • Cohort Studies
  • Databases, Factual
  • Female
  • Fertilization / drug effects
  • Fertilization in Vitro / methods*
  • Gonadotropin-Releasing Hormone / agonists*
  • Gonadotropin-Releasing Hormone / antagonists & inhibitors*
  • Gonadotropins / administration & dosage
  • Humans
  • Infertility, Female / drug therapy*
  • Infertility, Female / epidemiology
  • Luteolytic Agents / administration & dosage
  • Oocytes / cytology
  • Oocytes / drug effects
  • Ovarian Hyperstimulation Syndrome / epidemiology
  • Ovarian Hyperstimulation Syndrome / prevention & control
  • Ovulation / drug effects*
  • Ovulation / physiology
  • Ovulation Induction / methods*
  • Pregnancy
  • Pregnancy Rate
  • Risk Factors
  • Triptorelin Pamoate / administration & dosage

Substances

  • Gonadotropins
  • Luteolytic Agents
  • Triptorelin Pamoate
  • Gonadotropin-Releasing Hormone