GnRH agonist triggering affects the kinetics of embryo development: a comparative study

Gürbüz, Ali Sami; Göde, Funda; Uzman, Mehmet; Ince, Betul; Kaya, Melek; Ozcimen, Necati; Özçimen, Emel Ebru; Acar, Ali

doi:10.1186/s13048-016-0229-8

Cited by 18 publications

(8 citation statements)

References 30 publications

(31 reference statements)

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“…The study showed that oocytes retrieved after GnRHa use were fertilized earlier, and the embryo cleavage until the six-cell stage was shorter in the GnRHa group compared with the hCG group. However, later development was similar between the two groups (22). The authors in this study did not provide data to show the clinical significance of these differences.…”

Section: Discussionmentioning

confidence: 60%

Reproductive outcomes after a single dose of gonadotropin-releasing hormone agonist compared with human chorionic gonadotropin for the induction of final oocyte maturation in hyper-responder women aged 35–40 years

Tannus

Turki

Cohen

et al. 2017

Fertility and Sterility

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Section: Discussionmentioning

confidence: 60%

Reproductive outcomes after a single dose of gonadotropin-releasing hormone agonist compared with human chorionic gonadotropin for the induction of final oocyte maturation in hyper-responder women aged 35–40 years

Tannus

Turki

Cohen

et al. 2017

Fertility and Sterility

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“…As a result, the GnRHa group had a statistically higher number of FET cycles with blastocyst transfer (69.1% versus 55.6%; p =0.014) than the hCG group. Gurbuz et al (2016) showed that wherein time-lapse imaging of the embryos obtained from GnRHa, cleaved faster than the embryos obtained from hCG triggered cycles in antagonist protocols. It has been well established that early cleavage embryos results in a higher fraction of good-quality embryos and blastocysts ( Cruz et al, 2012 ; Wong et al, 2010 ) .…”

Section: Discussionmentioning

confidence: 99%

HCG trigger versus GnRH agonist trigger in PCOS patients undergoing IVF cycles: frozen embryo transfer outcomes

Krishna¹,

Suvarna²,

Maria³

et al. 2020

JBRA Assisted Reproduction

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Objective: The use of Gonadotrophin releasing hormone agonist (GnRHa), with freeze-all strategy followed by frozen embryo transfer (FET) has been found to eliminate the risk of ovarian hyperstimulation syndrome (OHSS) in women with polycystic ovarian syndrome (PCOS) undergoing IVF cycles. However, physicians still hesitate to routinely use GnRHa as a trigger, replacing human chorionic gonadotrophin (hCG), for concerns of compromised cycle outcome. We aimed to evaluate outcomes following the transfer of embryos in FET cycles obtained from GnRHa trigger in comparison with hCG trigger in PCOS patients of Asian origin. Methods: Prospective observational cohort study. 210 PCOS patients undergoing IVF in an antagonist protocol who were randomized in the previous study (to evaluate if GnRHa trigger is a better alternative than hCG in PCOS patients to prevent OHSS; Group A: GnRHa trigger (n=92)] and Group B: hCG trigger (n=101)], were followed up in FET cycles to assess the outcomes. Results: The odds of cumulative live birth rate per stimulation cycle favors GnRHa trigger against the hCG trigger [OR=2.15; (CI 1.2-3.83); p=0.008]. A significantly higher number of mature oocytes (19.1±11.7 versus 14.1±4.3; p<0.001) and blastocysts (4.2±1.63 versus 3.26±1.22; p<0.001) were available in the GnRHa group as compared to the hCG group. Conclusion: The cumulative live birth rate was better following transfer of frozen-thawed embryos generated from GnRHa-triggered cycles compared to hCG trigger. Hence, in PCOS undergoing IVF, as a good practice point, hCG trigger should be replaced by a GnRHa trigger with vitrification of all embryos followed by FET.

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“…Such technology has captured the imagination of practitioners as both a research tool (Costa-Borges et al, 2016;Hardarson et al, 2015;Mölder et al, 2015), comparing embryos resulting from various clinical conditions (Balakier et al, 2016;Gurbuz et al, 2016;Hashimoto et al, 2016;Kaihola et al, 2016;Lindgren et al, 2016), and as a potential prognosticator in clinical practice (Adamson et al, 2016;Chen et al, 2016;Kong et al, 2016;Liu et al, 2016;Milewski et al, 2015;Mizobe et al, 2016;Rubio et al, 2014;VerMilyea et al, 2014;Wu et al, 2016aWu et al, , 2016bYang et al, 2014), although some studies negate this (Freour et al, 2015;Wu et al, 2016aWu et al, , 2016b. Bronet et al (2015) even found distinctive morphokinetic differences between male and female embryos.…”

Section: Discussionmentioning

confidence: 99%

Live births after embryo selection using morphokinetics versus conventional morphology: a retrospective analysis

Fishel¹,

Campbell²,

Montgomery³

et al. 2017

Reproductive BioMedicine Online

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The increasing corpus of clinical studies using time-lapse imaging for embryo selection demonstrates considerable variation in study protocols and only limited-sized study cohorts. Outcome measures are based on implantation or clinical pregnancy; some predict blastulation from early cleavage-stage data, and few have evaluated live birth. Erroneously, most studies treat the embryos as independent variables and do not include patient or treatment variables in the statistical analyses. In this study, cohort size was 14,793 patients and 23,762 cycles. The incidence of live birth (n = 973 deliveries) after embryo selection by objective morphokinetic algorithms was compared with conventional embryology selection parameters (n = 6948 deliveries). A 19% increase in the incidence of live birth was observed when morphokinetic data were used to select embryos for the patient cohort aged younger than 38 years (OR 1.19 with 95% CI 1.06 to 1.34) using their own eggs, and an increase of 37% for oocyte recipients aged over 37 years (OR 1.370; 95% Cl 0.763 to 2.450). This is the largest study of the prospective use of time-lapse imaging algorithms in IVF reporting on live birth outcome, although the nature of purely a closed system versus standard incubation could not be assessed.

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GnRH agonist triggering affects the kinetics of embryo development: a comparative study

Cited by 18 publications

References 30 publications

Reproductive outcomes after a single dose of gonadotropin-releasing hormone agonist compared with human chorionic gonadotropin for the induction of final oocyte maturation in hyper-responder women aged 35–40 years

Reproductive outcomes after a single dose of gonadotropin-releasing hormone agonist compared with human chorionic gonadotropin for the induction of final oocyte maturation in hyper-responder women aged 35–40 years

HCG trigger versus GnRH agonist trigger in PCOS patients undergoing IVF cycles: frozen embryo transfer outcomes

Live births after embryo selection using morphokinetics versus conventional morphology: a retrospective analysis

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