Dual trigger with gonadotropin-releasing hormone agonist and standard dose human chorionic gonadotropin to improve oocyte maturity rates

Griffin, Daniel; Feinn, Richard; Engmann, Lawrence; Nulsen, John; Budinetz, T.H.; Benadiva, Claudio

doi:10.1016/j.fertnstert.2014.04.028

Cited by 99 publications

(97 citation statements)

References 23 publications

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“…The benefits of such combined or 'dual' triggers are being increasingly harnessed to improve the efficiency of donor oocyte-recipient cycles, elective oocyte cryopreservation, or fertility preservation prior to cancer therapy. It is also enthusing to note the increasing scope of dual triggers in challenging scenarios such as poor fertilization, abnormal follicular maturation and poor oocyte maturity [2,3]. We are grateful for Dr. Orvieto's timely letter that discusses additional indications for the administration of a dual trigger.…”

mentioning

confidence: 97%

The benefits of dual and double ovulatory triggers in assisted reproduction

Elias

Pereira

Palermo

2017

J Assist Reprod Genet

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mentioning

confidence: 97%

The benefits of dual and double ovulatory triggers in assisted reproduction

Elias

Pereira

Palermo

2017

J Assist Reprod Genet

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“…While hCG binds the LH receptor, it does not have FSH receptor activity. FSH has a role in the process of oocyte maturation; it induces LH receptor formation on the luteinized granulose cells and promotes oocyte maturation and cumulus expansion [11]. As opposed to hCG, a single dose of GnRHa induces an endogenous LH and FSH surge [8].…”

Section: Discussionmentioning

confidence: 99%

“…As opposed to hCG, a single dose of GnRHa induces an endogenous LH and FSH surge [8]. In addition, there are GnRH receptors on ovarian granulose cells, which have been shown to play a role in regulating ovulation [11,12]. It was hypothesized that the combined action of LH, FSH and GnRH may have a beneficial effect in improving oocyte maturation [11].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, there are GnRH receptors on ovarian granulose cells, which have been shown to play a role in regulating ovulation [11,12]. It was hypothesized that the combined action of LH, FSH and GnRH may have a beneficial effect in improving oocyte maturation [11]. Previous studies reported conflicting results regarding oocyte maturation rates [10,11,[13][14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

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Gonadotropin Releasing Hormone Agonist Final Oocyte Maturation and Human Chorionic Gonadotropin as Exclusive Luteal Support in Normal Responders

Beck-Fruchter

Baram

Geslevich

et al. 2018

Gynecol Obstet Invest

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Background/Aims: Gonadotropin releasing hormone (GnRH) agonist triggering results in an endogenous gonadotropin flare. Although it effectively stimulates ovulation, GnRH agonist triggers results in an early luteolysis and requires modification of the luteal support. The current study aims to evaluate GnRH agonist triggering with exclusive human chorionic gonadotropin (hCG) luteal support. Methods: In this prospective observational study, 56 normogonadotropic-assisted reproductive technology patients, stimulated using a GnRH-antagonist protocol, were studied. Final oocyte maturation was achieved with 0.2 mg triptorelin acetate followed by progesterone free luteal support with human choriogonadotropin (1,500 IU * 2). A control group was selected from a pool of 1,023 normogonadotropic patients who received Choriogonadotropin alfa for final oocyte maturation and progesterone suppositories for luteal support. Results: No significant difference was found for the number of oocytes, oocyte maturation rate, fertilization and implantation rate, clinical pregnancy rate (25 vs. 26.7%) and live birth rate (25 vs. 21.4%). Progesterone levels in conception cycles were significantly higher in the study group than corresponding levels in the control group. Conclusion: GnRH agonist triggering with exclusive hCG support may be a valid alternative to hCG triggering with progesterone support. This protocol combines the potential advantages of a physiological trigger with a simple, patient-friendly, luteal support.

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“…• "Double trigger": Griffin et al [20] added 1,000 IU of hCG with the GnRH agonist trigger dose, followed by intensive E 2 + P support.…”

Section: Luteal Support Based On a Single Hcg Dosementioning

confidence: 99%

A Rationale for Timing of Luteal Support Post Gonadotropin-Releasing Hormone Agonist Trigger

Kol

2018

Gynecol Obstet Invest

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Gonadotropin-releasing hormone (GnRH) antagonist-based ovarian stimulation protocol is gaining popularity. This protocol allows for the use of GnRH agonist as a trigger of final oocyte maturation, instead of the “gold standard” human chorionic gonadotropin (hCG) trigger. GnRH agonist trigger causes quick luteolysis, hence its widespread use in the context of ovarian hyperstimulation syndrome (OHSS) prevention. To secure pregnancy post GnRH agonist trigger, the luteal phase must be supplemented to counteract the luteolysis. Several luteal phase protocols post GnRH agonist trigger have been suggested, most notably based on increasing luteal luteinizing hormone (LH) activity (by adding LH or hCG). The current review aims at delineating a rationale for timing luteal support with a single hCG bolus post GnRH agonist trigger. The review also suggests a set of simple rules that must be followed when designing luteal phase support post GnRH agonist trigger.

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Dual trigger with gonadotropin-releasing hormone agonist and standard dose human chorionic gonadotropin to improve oocyte maturity rates

Cited by 99 publications

References 23 publications

The benefits of dual and double ovulatory triggers in assisted reproduction

The benefits of dual and double ovulatory triggers in assisted reproduction

Gonadotropin Releasing Hormone Agonist Final Oocyte Maturation and Human Chorionic Gonadotropin as Exclusive Luteal Support in Normal Responders

A Rationale for Timing of Luteal Support Post Gonadotropin-Releasing Hormone Agonist Trigger

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