GnRH Agonist versus hCG Trigger in Ovulation Induction with Intrauterine Insemination: A Randomized Controlled Trial

Lê, Minh Tâm; Nguyen, Dac Nguyen; Zolton, Jessica R.; Nguyen, Vu Quoc Huy; Truong, Quang Vinh; Cao, Ngọc Thành; DeCherney, Alan H.; Hill, Micah J.

doi:10.1155/2019/2487067

Cited by 9 publications

(7 citation statements)

References 34 publications

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“…There are some plausible biological mechanisms to support our findings concerning SBP. Medications to induce ovulation, such as gonadotropins and GnRH agonists, are used to achieve supraphysiological levels of estradiol [ 23 ]. Estrogens affect vascular health and blood pressure [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

History of infertility and pregnancy outcomes in Project Viva: a prospective study

Soria-Contreras

Perng

Rifas‐Shiman

et al. 2022

BMC Pregnancy Childbirth

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Background Infertility has been associated with the risk of adverse pregnancy outcomes. It is not clear whether infertility and underlying causes of infertility or the use of medically assisted reproduction (MAR) therapies are responsible for the observed associations. In this study, we aimed to evaluate the association of history of infertility with pregnancy outcomes and identify whether the associations, if present, differed by subgroups defined by the use of MAR. Methods Prospective study of 2201 pregnant women from the Boston-area Project Viva cohort. The exposure was history of infertility based on self-reported time to pregnancy ≥12 mo (or ≥ 6 mo if ≥35 y) or use of MAR; a diagnosis of infertility or claims for infertility treatments from medical records. The outcomes included: gestational glucose tolerance (gestational diabetes, impaired glucose tolerance, isolated hyperglycemia vs. normoglycemia), hypertensive disorders (gestational hypertension/preeclampsia vs. normotension), gestational weight gain (inadequate/excessive vs. adequate), systolic (SBP) and diastolic blood pressure, birthweight-for-gestational age z-score (tertile 2 and 3 vs. 1), preterm birth (<37 vs. ≥37 weeks at delivery), and birth outcome (pregnancy loss vs. live birth). We performed linear and logistic/multinomial regression analyses adjusted for age, race/ethnicity, age at menarche, pre-pregnancy BMI, and prenatal smoking. Results Mean (SD) age was 32.0 (5.0) years, and 18.8% of women had history of infertility, 32.6% of whom used MAR. SBP across pregnancy was 0.72 mmHg higher in women with vs. without infertility (95% CI 0.02, 1.42). The associations were stronger among women who used MAR (β 1.32 mmHg, 95% CI 0.21, 2.44), especially among those who used gonadotropins or gonadotropin-releasing hormone [GnRH] agonists (β 1.91 mmHg, 95% CI 0.48, 3.35). Other outcomes were not associated with history of infertility. Conclusions A history of infertility was associated with higher SBP during pregnancy, with stronger associations among those who used gonadotropins or GnRH agonists. Future studies are needed to confirm these findings and determine their clinical implications.

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Section: Discussionmentioning

confidence: 99%

History of infertility and pregnancy outcomes in Project Viva: a prospective study

Soria-Contreras

Perng

Rifas‐Shiman

et al. 2022

BMC Pregnancy Childbirth

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“…Other than HCG, GnRH-a has been used as an alternative to induce ovulation in the last two decades. GnRH agonists induce the endogenous surge of LH and FSH by their flare-up effect, which is helpful in triggering ovulation and decreasing the risk of OHSS [ 1 – 3 ]. Ovulation triggers with hCG or GnRH are widely used in the IUI cycle.…”

Section: Discussionmentioning

confidence: 99%

“…These studies reveal that the final maturation of oocyte with dual trigger improves the number of mature oocytes (MII) and oocyte quality, which is reflected by the higher number of good quality embryos, thus improving the clinical pregnancy rate. HCG has traditionally been used as the gold standard for triggering oocyte maturation in controlled ovarian stimulation cycles [ 1 – 3 , 24 ]. GnRH-a is one of the triggers of final oocyte maturation that is used as an alternative to hCG to prevent OHSS in PCOS patients [ 16 – 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…IUI is indicated for the treatment of unexplained infertility, mild male factor, cervical factor, anovulation, and minimal to mild endometriosis [ 1 , 2 ]. Success rates of IUI range between 10% and 20% per treatment [ 1 , 3 ]. Various methods are performed to increase the success rates of IUI, including ovarian stimulation, sperm preparation, endometrial preparation, ovulation trigger, increasing progesterone level, and monitoring of follicles [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

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Dual trigger with gonadotropin-releasing hormone agonist and recombinant human chorionic gonadotropin improves the outcome of intrauterine insemination

Halim

Lubis

2022

Obstet Gynecol Sci

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The objective of this study was to evaluate the effectiveness of dual trigger, which is a combination of gonadotropin-releasing agonist (GnRH-a) and recombinant human chorionic gonadotropin (hCG) in the final oocyte maturation, in the outcome of intrauterine insemination (IUI). MethodsThis retrospective observational study was conducted from January 2016 to October 2018 and involved 639 IUI cycles at the Halim Fertility Center, Indonesia. Controlled ovarian stimulation was performed during IUI cycles. The ovulation triggers were divided into two groups: group I received a combination of GnRH-a and recombinant hCG as a dual trigger, and group II received only recombinant hCG as a single trigger. The baseline characteristics, cycle parameters, and IUI outcomes of both groups were compared. ResultsOur study included a total of 639 IUI cycles, 334 were in the dual trigger group and 305 in the single trigger group. The clinical pregnancy rates were significantly higher in the dual trigger group than in the single trigger group (P<0.001). Based on the multivariate analysis, the dual trigger increased the clinical pregnancy rate by 2.524 times than that by the single trigger. ConclusionOur data showed that the dual trigger combination of GnRH-a and recombinant hCG significantly improves the outcome of intrauterine insemination.

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“…Human Chorionic Gonadotropin (hCG) can be used as a trigger; in cases in which an antagonist is used in pituitary block, a GnRH agonist should be chosen ( Alyasin et al ., 2016 ; Le et al ., 2019 ). hCG is a gonadotrophic glycoprotein hormone, produced mainly by placental trophoblasts, as the LH produced by the pituitary gland and used in the final maturation of oocytes.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Protocols of Controlled Ovarian Stimulation in Obtaining Mature Oocytes (MII): Retrospective Study on Assisted Reproductive Technology Procedures

Martins¹,

Ruivo²,

Vaz-Oliani³

et al. 2022

JBRA

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Objective To understand which of the controlled ovarian stimulation (COS) protocols used in different patients are associated with greater amounts of oocytes retrieved. Methods The study population was divided into three groups, considering AMH and AFC to obtain the Ovarian Response Predictor Index (ORPI); they were grouped into: G1-Low Reserve (ORPI <0.5); G2-Normal Reserve (ORPI:0.5-0.9); and G3-High Reserve (ORPI≥0.9). 246 cycles were selected in which COS was used: recombinant FSH - follitropin alfa or beta (Protocol 1) or corifollitropin alfa (Protocol 2), both associated with urinary HMG and the GnRH antagonist, with the trigger performed using recombinant hCG or GnRH agonist. Results The number of oocytes obtained was higher in protocol 1 in all groups, with higher counts seen in G1 than in G2 or G3. The number of days required in COS for protocol 2 was greater than for protocol 1 in all groups. The total dose of recombinant FSH alfa or beta / urinary HMG used in protocol 1 was inversely proportional to the ovarian reserve. The lower the ORPI, the greater the average number of international units administered. In protocol 2, there was a need to supplement with higher doses of urinary HMG when compared to protocol 1. The dosage of the GnRH antagonist was dependent on the number of COS days until the trigger was used. In obtaining MII oocytes, the percentages were similar regardless of the trigger used. Conclusions The use of follitropin leads to greater numbers of retrieved oocytes than corifollitropin alfa in all ORPIs. The dose of recombinant FSH used with urinary HMG increases inversely proportional to the ORPI value. The fixed dose of recombinant FSH deposit requires a sharp increase in the dose of urinary HMG.

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GnRH Agonist versus hCG Trigger in Ovulation Induction with Intrauterine Insemination: A Randomized Controlled Trial

Cited by 9 publications

References 34 publications

History of infertility and pregnancy outcomes in Project Viva: a prospective study

History of infertility and pregnancy outcomes in Project Viva: a prospective study

Dual trigger with gonadotropin-releasing hormone agonist and recombinant human chorionic gonadotropin improves the outcome of intrauterine insemination

Evaluation of Protocols of Controlled Ovarian Stimulation in Obtaining Mature Oocytes (MII): Retrospective Study on Assisted Reproductive Technology Procedures

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