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

• Published in: Gynecological endocrinology 2013-01, Vol.29 (1), p.51-53
• Main Authors: Orvieto, Raoul, Nahum, Ravit, Zohav, Efraim, Liberty, Gad, Anteby, Eyal Y., Meltcer, Simion
• Format: Article
• Language: English
• Subjects: Adult; COH; Cohort Studies; Databases, Factual; Female; Fertilization - drug effects; Fertilization in Vitro - methods; GnRH-agonist; Gonadotropin-Releasing Hormone - agonists; Gonadotropin-Releasing Hormone - antagonists & inhibitors; Gonadotropins - administration & dosage; Humans; Infertility, Female - drug therapy; Infertility, Female - epidemiology; IVF outcome; Luteolytic Agents - administration & dosage; multidose GnRH-antagonist; Oocytes - cytology; Oocytes - drug effects; Ovarian Hyperstimulation Syndrome - epidemiology; Ovarian Hyperstimulation Syndrome - prevention & control; Ovulation - drug effects; Ovulation - physiology; Ovulation Induction - methods; ovulation trigger; Pregnancy; Pregnancy Rate; Risk Factors; Triptorelin Pamoate - administration & dosage; ultrashort GnRH-agonist
• ISSN: 0951-3590; 1473-0766
• DOI: 10.3109/09513590.2012.705376

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.