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Effect of GnRH agonist trigger with or without low-dose hCG on reproductive outcomes for PCOS women with freeze-all strategy: a propensity score matching study
Purpose This study aimed to compare the effect of gonadotropin-releasing hormone agonist (GnRHa) trigger alone versus dual trigger comprising GnRHa and low-dose human chorionic gonadotropin (hCG) on reproductive outcomes in patients with polycystic ovary syndrome (PCOS) who received the freeze-all s...
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| Published in: | Archives of gynecology and obstetrics 2024-02, Vol.309 (2), p.679-688 |
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| container_title | Archives of gynecology and obstetrics |
| container_volume | 309 |
| creator | Wang, Qiaofeng Wan, Qi Li, Tian Wang, Xuejiao Hu, Yuling Zhong, Zhaohui Pu, Kexue Ding, Yubin Tang, Xiaojun |
| description | Purpose
This study aimed to compare the effect of gonadotropin-releasing hormone agonist (GnRHa) trigger alone versus dual trigger comprising GnRHa and low-dose human chorionic gonadotropin (hCG) on reproductive outcomes in patients with polycystic ovary syndrome (PCOS) who received the freeze-all strategy.
Methods
A total of 615 cycles were included in this retrospective cohort study. Propensity score matching (PSM) was performed to control potential confounding factors between GnRHa-trigger group (0.2 mg GnRHa) and dual-trigger group (0.2 mg GnRHa plus 1000/2000 IU hCG) in a 1:1 ratio. Multivariate logistic regression was applied to estimate the association between trigger methods and reproductive outcomes.
Results
After PSM, patients with dual trigger (
n
= 176) had more oocytes retrieved, mature oocytes, and 2PN embryos compared to that with GnRHa trigger alone. However, the oocytes maturation rate, normal fertilization rate, and frozen embryos between the two groups were not statistically different. The incidence of ovarian hyperstimulation syndrome (OHSS) (14.8% vs. 2.8%,
P
|
| doi_str_mv | 10.1007/s00404-023-07285-1 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2895699269</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2918139184</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-3be6867f29c3696eea47679a773824b4f1e76791baa838968caa77c302f6642f3</originalsourceid><addsrcrecordid>eNp9kctuFDEQRS0EIiHwAyxQSWzYNPgVt80OjcIEKVIQj7Xl8ZR7OupuD7ab0fAz_CoOHR5iwcblUp17q6RLyFNGXzJK21eZUkllQ7loaMv1ecPukVMmBa8tY_f_-p-QRznfUMq41uohORGaCi4ZOyXfL0JAXyAGWE8fLsF1cepzgZL6rsMEh77sIC41zgWGeGi2MSPsVmuIEyTcp7idfem_IlTAxxEzhKp4v7r-CIfaTotJSIjfsHHDALkkV7A7vgYHVb7HKfflCNnHhDC64nf91FVq3h4fkwfBDRmf3NUz8vntxafVZXN1vX63enPVeMFVacQGlVZt4MYLZRSik61qjWtbobncyMDwtmcb57TQRmnv6swLyoNSkgdxRl4svvWeLzPmYsc-exwGN2Gcs-XanCtjuDIVff4PehPnNNXrLDdMM1EfWSm-UD7FnBMGu0_96NLRMmpv47NLfLbGZ3_GZ1kVPbuznjcjbn9LfuVVAbEAuY6mGtCf3f-x_QHwvKaA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2918139184</pqid></control><display><type>article</type><title>Effect of GnRH agonist trigger with or without low-dose hCG on reproductive outcomes for PCOS women with freeze-all strategy: a propensity score matching study</title><source>Springer Link</source><creator>Wang, Qiaofeng ; Wan, Qi ; Li, Tian ; Wang, Xuejiao ; Hu, Yuling ; Zhong, Zhaohui ; Pu, Kexue ; Ding, Yubin ; Tang, Xiaojun</creator><creatorcontrib>Wang, Qiaofeng ; Wan, Qi ; Li, Tian ; Wang, Xuejiao ; Hu, Yuling ; Zhong, Zhaohui ; Pu, Kexue ; Ding, Yubin ; Tang, Xiaojun</creatorcontrib><description>Purpose
This study aimed to compare the effect of gonadotropin-releasing hormone agonist (GnRHa) trigger alone versus dual trigger comprising GnRHa and low-dose human chorionic gonadotropin (hCG) on reproductive outcomes in patients with polycystic ovary syndrome (PCOS) who received the freeze-all strategy.
Methods
A total of 615 cycles were included in this retrospective cohort study. Propensity score matching (PSM) was performed to control potential confounding factors between GnRHa-trigger group (0.2 mg GnRHa) and dual-trigger group (0.2 mg GnRHa plus 1000/2000 IU hCG) in a 1:1 ratio. Multivariate logistic regression was applied to estimate the association between trigger methods and reproductive outcomes.
Results
After PSM, patients with dual trigger (
n
= 176) had more oocytes retrieved, mature oocytes, and 2PN embryos compared to that with GnRHa trigger alone. However, the oocytes maturation rate, normal fertilization rate, and frozen embryos between the two groups were not statistically different. The incidence of ovarian hyperstimulation syndrome (OHSS) (14.8% vs. 2.8%,
P
< 0.001) and moderate/severe OHSS (11.4% vs. 1.7%,
P
< 0.001) were significantly higher in dual-trigger group than in GnRHa-alone group. Logistic regression analysis showed the adjusted odds ratio of dual trigger was 5.971 (95% confidence interval 2.201–16.198,
P
< 0.001) for OHSS. The pregnancy and single neonatal outcomes were comparable between the two groups (
P
> 0.05).
Conclusion
For PCOS women with freeze-all strategy, GnRHa trigger alone decreased the risk of OHSS without damaging oocyte maturation and achieved satisfactory pregnancy outcomes.</description><identifier>ISSN: 1432-0711</identifier><identifier>ISSN: 0932-0067</identifier><identifier>EISSN: 1432-0711</identifier><identifier>DOI: 10.1007/s00404-023-07285-1</identifier><identifier>PMID: 38032411</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Chorionic Gonadotropin - pharmacology ; Drug dosages ; Endocrinology ; Female ; Fertilization in Vitro - methods ; Gonadotropin-Releasing Hormone - pharmacology ; Gynecologic Endocrinology and Reproductive Medicine ; Gynecology ; Human Genetics ; Humans ; Infant, Newborn ; Medicine ; Medicine & Public Health ; Obstetrics/Perinatology/Midwifery ; Oocytes ; Ovarian Hyperstimulation Syndrome - epidemiology ; Ovarian Hyperstimulation Syndrome - prevention & control ; Ovulation Induction - methods ; Polycystic ovary syndrome ; Polycystic Ovary Syndrome - complications ; Polycystic Ovary Syndrome - drug therapy ; Pregnancy ; Pregnancy Rate ; Propensity Score ; Regression analysis ; Retrospective Studies</subject><ispartof>Archives of gynecology and obstetrics, 2024-02, Vol.309 (2), p.679-688</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-3be6867f29c3696eea47679a773824b4f1e76791baa838968caa77c302f6642f3</cites><orcidid>0000-0003-3486-1020</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38032411$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Qiaofeng</creatorcontrib><creatorcontrib>Wan, Qi</creatorcontrib><creatorcontrib>Li, Tian</creatorcontrib><creatorcontrib>Wang, Xuejiao</creatorcontrib><creatorcontrib>Hu, Yuling</creatorcontrib><creatorcontrib>Zhong, Zhaohui</creatorcontrib><creatorcontrib>Pu, Kexue</creatorcontrib><creatorcontrib>Ding, Yubin</creatorcontrib><creatorcontrib>Tang, Xiaojun</creatorcontrib><title>Effect of GnRH agonist trigger with or without low-dose hCG on reproductive outcomes for PCOS women with freeze-all strategy: a propensity score matching study</title><title>Archives of gynecology and obstetrics</title><addtitle>Arch Gynecol Obstet</addtitle><addtitle>Arch Gynecol Obstet</addtitle><description>Purpose
This study aimed to compare the effect of gonadotropin-releasing hormone agonist (GnRHa) trigger alone versus dual trigger comprising GnRHa and low-dose human chorionic gonadotropin (hCG) on reproductive outcomes in patients with polycystic ovary syndrome (PCOS) who received the freeze-all strategy.
Methods
A total of 615 cycles were included in this retrospective cohort study. Propensity score matching (PSM) was performed to control potential confounding factors between GnRHa-trigger group (0.2 mg GnRHa) and dual-trigger group (0.2 mg GnRHa plus 1000/2000 IU hCG) in a 1:1 ratio. Multivariate logistic regression was applied to estimate the association between trigger methods and reproductive outcomes.
Results
After PSM, patients with dual trigger (
n
= 176) had more oocytes retrieved, mature oocytes, and 2PN embryos compared to that with GnRHa trigger alone. However, the oocytes maturation rate, normal fertilization rate, and frozen embryos between the two groups were not statistically different. The incidence of ovarian hyperstimulation syndrome (OHSS) (14.8% vs. 2.8%,
P
< 0.001) and moderate/severe OHSS (11.4% vs. 1.7%,
P
< 0.001) were significantly higher in dual-trigger group than in GnRHa-alone group. Logistic regression analysis showed the adjusted odds ratio of dual trigger was 5.971 (95% confidence interval 2.201–16.198,
P
< 0.001) for OHSS. The pregnancy and single neonatal outcomes were comparable between the two groups (
P
> 0.05).
Conclusion
For PCOS women with freeze-all strategy, GnRHa trigger alone decreased the risk of OHSS without damaging oocyte maturation and achieved satisfactory pregnancy outcomes.</description><subject>Chorionic Gonadotropin - pharmacology</subject><subject>Drug dosages</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Fertilization in Vitro - methods</subject><subject>Gonadotropin-Releasing Hormone - pharmacology</subject><subject>Gynecologic Endocrinology and Reproductive Medicine</subject><subject>Gynecology</subject><subject>Human Genetics</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Obstetrics/Perinatology/Midwifery</subject><subject>Oocytes</subject><subject>Ovarian Hyperstimulation Syndrome - epidemiology</subject><subject>Ovarian Hyperstimulation Syndrome - prevention & control</subject><subject>Ovulation Induction - methods</subject><subject>Polycystic ovary syndrome</subject><subject>Polycystic Ovary Syndrome - complications</subject><subject>Polycystic Ovary Syndrome - drug therapy</subject><subject>Pregnancy</subject><subject>Pregnancy Rate</subject><subject>Propensity Score</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><issn>1432-0711</issn><issn>0932-0067</issn><issn>1432-0711</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kctuFDEQRS0EIiHwAyxQSWzYNPgVt80OjcIEKVIQj7Xl8ZR7OupuD7ab0fAz_CoOHR5iwcblUp17q6RLyFNGXzJK21eZUkllQ7loaMv1ecPukVMmBa8tY_f_-p-QRznfUMq41uohORGaCi4ZOyXfL0JAXyAGWE8fLsF1cepzgZL6rsMEh77sIC41zgWGeGi2MSPsVmuIEyTcp7idfem_IlTAxxEzhKp4v7r-CIfaTotJSIjfsHHDALkkV7A7vgYHVb7HKfflCNnHhDC64nf91FVq3h4fkwfBDRmf3NUz8vntxafVZXN1vX63enPVeMFVacQGlVZt4MYLZRSik61qjWtbobncyMDwtmcb57TQRmnv6swLyoNSkgdxRl4svvWeLzPmYsc-exwGN2Gcs-XanCtjuDIVff4PehPnNNXrLDdMM1EfWSm-UD7FnBMGu0_96NLRMmpv47NLfLbGZ3_GZ1kVPbuznjcjbn9LfuVVAbEAuY6mGtCf3f-x_QHwvKaA</recordid><startdate>20240201</startdate><enddate>20240201</enddate><creator>Wang, Qiaofeng</creator><creator>Wan, Qi</creator><creator>Li, Tian</creator><creator>Wang, Xuejiao</creator><creator>Hu, Yuling</creator><creator>Zhong, Zhaohui</creator><creator>Pu, Kexue</creator><creator>Ding, Yubin</creator><creator>Tang, Xiaojun</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3486-1020</orcidid></search><sort><creationdate>20240201</creationdate><title>Effect of GnRH agonist trigger with or without low-dose hCG on reproductive outcomes for PCOS women with freeze-all strategy: a propensity score matching study</title><author>Wang, Qiaofeng ; Wan, Qi ; Li, Tian ; Wang, Xuejiao ; Hu, Yuling ; Zhong, Zhaohui ; Pu, Kexue ; Ding, Yubin ; Tang, Xiaojun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-3be6867f29c3696eea47679a773824b4f1e76791baa838968caa77c302f6642f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Chorionic Gonadotropin - pharmacology</topic><topic>Drug dosages</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Fertilization in Vitro - methods</topic><topic>Gonadotropin-Releasing Hormone - pharmacology</topic><topic>Gynecologic Endocrinology and Reproductive Medicine</topic><topic>Gynecology</topic><topic>Human Genetics</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Obstetrics/Perinatology/Midwifery</topic><topic>Oocytes</topic><topic>Ovarian Hyperstimulation Syndrome - epidemiology</topic><topic>Ovarian Hyperstimulation Syndrome - prevention & control</topic><topic>Ovulation Induction - methods</topic><topic>Polycystic ovary syndrome</topic><topic>Polycystic Ovary Syndrome - complications</topic><topic>Polycystic Ovary Syndrome - drug therapy</topic><topic>Pregnancy</topic><topic>Pregnancy Rate</topic><topic>Propensity Score</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Qiaofeng</creatorcontrib><creatorcontrib>Wan, Qi</creatorcontrib><creatorcontrib>Li, Tian</creatorcontrib><creatorcontrib>Wang, Xuejiao</creatorcontrib><creatorcontrib>Hu, Yuling</creatorcontrib><creatorcontrib>Zhong, Zhaohui</creatorcontrib><creatorcontrib>Pu, Kexue</creatorcontrib><creatorcontrib>Ding, Yubin</creatorcontrib><creatorcontrib>Tang, Xiaojun</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of gynecology and obstetrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Qiaofeng</au><au>Wan, Qi</au><au>Li, Tian</au><au>Wang, Xuejiao</au><au>Hu, Yuling</au><au>Zhong, Zhaohui</au><au>Pu, Kexue</au><au>Ding, Yubin</au><au>Tang, Xiaojun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of GnRH agonist trigger with or without low-dose hCG on reproductive outcomes for PCOS women with freeze-all strategy: a propensity score matching study</atitle><jtitle>Archives of gynecology and obstetrics</jtitle><stitle>Arch Gynecol Obstet</stitle><addtitle>Arch Gynecol Obstet</addtitle><date>2024-02-01</date><risdate>2024</risdate><volume>309</volume><issue>2</issue><spage>679</spage><epage>688</epage><pages>679-688</pages><issn>1432-0711</issn><issn>0932-0067</issn><eissn>1432-0711</eissn><abstract>Purpose
This study aimed to compare the effect of gonadotropin-releasing hormone agonist (GnRHa) trigger alone versus dual trigger comprising GnRHa and low-dose human chorionic gonadotropin (hCG) on reproductive outcomes in patients with polycystic ovary syndrome (PCOS) who received the freeze-all strategy.
Methods
A total of 615 cycles were included in this retrospective cohort study. Propensity score matching (PSM) was performed to control potential confounding factors between GnRHa-trigger group (0.2 mg GnRHa) and dual-trigger group (0.2 mg GnRHa plus 1000/2000 IU hCG) in a 1:1 ratio. Multivariate logistic regression was applied to estimate the association between trigger methods and reproductive outcomes.
Results
After PSM, patients with dual trigger (
n
= 176) had more oocytes retrieved, mature oocytes, and 2PN embryos compared to that with GnRHa trigger alone. However, the oocytes maturation rate, normal fertilization rate, and frozen embryos between the two groups were not statistically different. The incidence of ovarian hyperstimulation syndrome (OHSS) (14.8% vs. 2.8%,
P
< 0.001) and moderate/severe OHSS (11.4% vs. 1.7%,
P
< 0.001) were significantly higher in dual-trigger group than in GnRHa-alone group. Logistic regression analysis showed the adjusted odds ratio of dual trigger was 5.971 (95% confidence interval 2.201–16.198,
P
< 0.001) for OHSS. The pregnancy and single neonatal outcomes were comparable between the two groups (
P
> 0.05).
Conclusion
For PCOS women with freeze-all strategy, GnRHa trigger alone decreased the risk of OHSS without damaging oocyte maturation and achieved satisfactory pregnancy outcomes.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38032411</pmid><doi>10.1007/s00404-023-07285-1</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-3486-1020</orcidid></addata></record> |
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| subjects | Chorionic Gonadotropin - pharmacology Drug dosages Endocrinology Female Fertilization in Vitro - methods Gonadotropin-Releasing Hormone - pharmacology Gynecologic Endocrinology and Reproductive Medicine Gynecology Human Genetics Humans Infant, Newborn Medicine Medicine & Public Health Obstetrics/Perinatology/Midwifery Oocytes Ovarian Hyperstimulation Syndrome - epidemiology Ovarian Hyperstimulation Syndrome - prevention & control Ovulation Induction - methods Polycystic ovary syndrome Polycystic Ovary Syndrome - complications Polycystic Ovary Syndrome - drug therapy Pregnancy Pregnancy Rate Propensity Score Regression analysis Retrospective Studies |
| title | Effect of GnRH agonist trigger with or without low-dose hCG on reproductive outcomes for PCOS women with freeze-all strategy: a propensity score matching study |
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