Endocrinology: Triggering of ovulation using a gonadotrophin-releasing hormone agonist does not prevent ovarian hyperstimulation syndrome

Meer, Suzan van der; Gerris, Jan; Joostens, M.; Tas, Burcu Tufan

doi:10.1093/oxfordjournals.humrep.a137903

Cited by 37 publications

(8 citation statements)

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“…Although luteolysis induced by GnRH agonist does not exclude the possibility of OHSS (9,30,31), in our study none of the donors that ovulated with the GnRH agonist suffered from OHSS; on the other hand, four cases of mild OHSS were detected in the group of donors receiving rhCG (Table 1). Therefore, in our opinion, the use of GnRH agonist instead of hCG to induce final oocyte maturation can be a good alternative to avoid OHSS in assisted reproduction treatments (1,4,6,31).…”

Section: Discussioncontrasting

confidence: 59%

Triggering ovulation with gonadotropin-releasing hormone agonists does not compromise embryo implantation rates

Acevedo¹,

Gómez-Palomares²,

Ricciarelli³

et al. 2006

Fertility and Sterility

143

112

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Section: Discussioncontrasting

confidence: 59%

Triggering ovulation with gonadotropin-releasing hormone agonists does not compromise embryo implantation rates

Acevedo¹,

Gómez-Palomares²,

Ricciarelli³

et al. 2006

Fertility and Sterility

143

112

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“…The latter may result in abnormal LH secretion during the early luteal phase, reduced LH support for the corpora lutea, reduced ovarian steroidogenesis and early luteolysis (Itskovitz et al, 1991;Van der Meer et al, 1993;Khoury et al, 1994;Gerris et al, 1995). The rapid and profound decline in the activity of the corpora lutea is probably the key event in the prevention of OHSS (Itskovitz et al, 1993), and is supported by several observations: (i) an abrupt fall in oestradiol and progesterone levels was recorded in the first days of the luteal phase in cases where luteal support was not given (Lewit et al, 1995); (ii) a consequent short luteal phase lasting 9-10 days (Lewit et al, 1995); (rii) reduced progesterone production by cumulus and granulosa cells obtained from women treated with midcycle GnRHa for the induction of LH surge was observed (Khoury et al, 1994).…”

Section: Discussionmentioning

confidence: 99%

Endocrinology: Comparison of gonadotrophin-releasing hormone analogues and human chorionic gonadotrophin for the induction of ovulation and prevention of ovarian hyperstimulation syndrome: a case-control study

et al. 1996

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Gonadotrophin-releasing hormone analogue (GnRHa) has been suggested as an alternative to human chorionic gonadotrophin (HCG) for triggering ovulation, while preventing ovarian hyperstimulation syndrome (OHSS). Since a prospective, controlled study would be unethical at this point, we used a retrospective, case-self control approach to compare GnRHa with HCG in that context. A group of 16 in-vitro fertilization (IVF) patients who had severe OHSS in previous cycles, in which HCG was given to trigger ovulation, were studied in subsequent cycles in which GnRHa was used. Each GnRHa cycle (case) was compared to a previous HCG cycle that resulted in OHSS (self control). None of these subsequent cycles resulted in severe OHSS. The use of GnRHa did not affect the number of oocytes retrieved or their quality. Serum oestradiol concentrations on the day of ovulation triggering were significantly (P < 0.01) higher in the GnRHa cycles compared to HCG cycles. Exogenous progesterone and oestradiol were effective in maintaining relatively constant serum oestradiol and progesterone serum concentrations during the luteal phase. Pregnancy rate per cycle was similar in the two groups. In conclusion, the use of GnRHa to induce ovulation in IVF patients, who are at high risk for developing OHSS, effectively eliminates this risk without affecting other parameters of the stimulation cycle.

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“…A single dose of GnRHa induces an endogenous LH and FSH surge similar to that of the natural cycle, sufficiently high enough to successfully induce final oocyte maturation. This modality of triggering was initially advocated in the late 1980s and early 1990s (Emperaire, 1994;Gonen et al, 1990;Itskovitz et al, 1991;Itskovitz-Eldor et al, 1993;Lanzone et al, 1989;Lewit et al, 1996;Segal and Casper, 1992;van der Meer et al, 1993). Soon after the introduction of GnRHa to trigger oocyte maturation during IVF treatment, however, its use was hampered by the introduction of GnRHa for pituitary downregulation during ovarian stimulation.…”

Section: Introductionmentioning

confidence: 99%

GnRH agonist trigger for the induction of oocyte maturation in GnRH antagonist IVF cycles: a SWOT analysis

Engmann

Benadiva

Humaıdan

2016

Reproductive BioMedicine Online

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Gonadotrophin releasing hormone agonist (GnRHa) trigger is effective in the induction of oocyte maturation and prevention of ovarian hyperstimulation syndrome during IVF treatment. This trigger concept, however, results in early corpora lutea demise and consequently luteal phase dysfunction and impaired endometrial receptivity. The aim of this strenghths, weaknesses, opportunities and threats analysis was to summarize the progress made over the past 15 years to optimize ongoing pregnancy rates after GnRHa trigger. The advantages and potential drawbacks of this type of triggering are reviewed. The current approach to the management of GnRHa trigger in autologous cycles is based on the peak serum oestradiol level or follicle number and aims at a fresh embryo transfer or a segmentation approach with elective cryopreservation policy. We recommend intensive luteal support with transdermal oestradiol and intramuscular progesterone alone if peak serum oestradiol is 4000 or more pg/ml after GnRHa trigger or dual trigger with GnRHa and HCG 1000 IU if peak serum oestradiol is less than 4000 pg/mL. On the contrary, we recommend HCG 1500 IU 35 h after GnRHa trigger if there are less than 25 follicles, or freeze all oocytes or embryos if there are over 25 follicles.

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Endocrinology: Triggering of ovulation using a gonadotrophin-releasing hormone agonist does not prevent ovarian hyperstimulation syndrome

Cited by 37 publications

References 0 publications

Triggering ovulation with gonadotropin-releasing hormone agonists does not compromise embryo implantation rates

Triggering ovulation with gonadotropin-releasing hormone agonists does not compromise embryo implantation rates

Endocrinology: Comparison of gonadotrophin-releasing hormone analogues and human chorionic gonadotrophin for the induction of ovulation and prevention of ovarian hyperstimulation syndrome: a case-control study

GnRH agonist trigger for the induction of oocyte maturation in GnRH antagonist IVF cycles: a SWOT analysis

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