Lag time from ovulation trigger to oocyte aspiration and oocyte maturity in assisted reproductive technology cycles: a retrospective study

Weiss, Amir; Neril, Rebecca; Geslevich, Joel; Lavee, Michal; Beck-Fruchter, Ronit; Golan, Joanne; Shalev, Eliezer

doi:10.1016/j.fertnstert.2014.04.041

Cited by 25 publications

(14 citation statements)

References 22 publications

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“…Follicles can grow “postmature” or ovulate prematurely if the interval is too long, while a short interval is not sufficient for oocyte maturation and makes retrieval more difficult. However, previous studies (34, 48, 49) have failed to identify an optimal interval and produced controversial results on whether prolongation of the interval would improve oocyte retrieval outcomes. One possible explanation may be that none of these studies took the follicle size profiles on trigger day or the hormonal response after trigger into account.…”

Section: Discussionmentioning

confidence: 99%

A Higher Estradiol Rise After Dual Trigger in Progestin-Primed Ovarian Stimulation Is Associated With a Lower Oocyte and Mature Oocyte Yield in Normal Responders

et al. 2019

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Background: Prior studies have shown that patients with a >10% estradiol (E2) rise after trigger had more oocytes retrieved than plateauing or decreasing E2 responders. However, multiple follicles develop at different stages of maturation during controlled ovarian stimulation (COS) and may exhibit different responses to trigger. The association between the magnitude of E2 increase and oocyte retrieval outcomes is still unclear.Methods: This was a retrospective cohort study of 2,898 women undergoing their first COS cycles with normal response from January 2014 to December 2017 at a tertiary-care academic medical center. Patients were categorized into five groups according to the percentage increase in E2 levels before and after dual trigger: <10.0%, 10.0–19.9%, 20.0–29.9%, 30.0–39.9%, and ≥40.0%. Univariable and multivariable linear regression analysis were performed to explore the association between E2 increase and oocyte/mature oocyte yield, while logistic regression was used to assess its effect on low oocyte/mature oocyte yield (<10th percentile).Results: The post-trigger E2 increase was negatively associated with both oocyte yield (P-trend < 0.001, adjusted P-trend = 0.033) and mature oocyte yield (P-trend < 0.001, adjusted P-trend = 0.002). Compared with a <10.0% E2 increase after trigger, patients with a ≥40.0% rise had fewer mature oocyte yield [adjusted mean absolute difference [MD] = −5.2, 95% confidence interval [CI]: −8.2–−1.8] and higher risk of low mature oocyte yield (adjusted odds ratio [OR] = 1.64, 95% CI: 1.04–2.60), whereas no statistical significance was found in oocyte yield (adjusted MD = −2.7, 95% CI: −6.1–0.8) and low oocyte yield (adjusted OR = 1.48, 95% CI: 0.96–2.28). In addition, the rates of implantation, positive pregnancy test, clinical pregnancy, ongoing pregnancy, pregnancy loss, and live birth were comparable among the 1,942 frozen embryo transfer cycles with embryos originating from different groups of E2 increase (all P > 0.05).Conclusions: A higher E2 rise after dual trigger is independently associated with a lower oocyte and mature oocyte yield in normal responders. Further studies are needed to explore the efficacy of individualized time interval from trigger to oocyte retrieval based on the magnitude of E2 increase after trigger.

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Section: Discussionmentioning

confidence: 99%

A Higher Estradiol Rise After Dual Trigger in Progestin-Primed Ovarian Stimulation Is Associated With a Lower Oocyte and Mature Oocyte Yield in Normal Responders

et al. 2019

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“…Estradiol and progesterone levels were typically measured on the day of trigger or one day before. Follicle aspiration was scheduled 34 to 37 h after oocyte maturation trigger [ 32 ].…”

Section: Methodsmentioning

confidence: 99%

Ectopic pregnancy risk factors for ART patients undergoing the GnRH antagonist protocol: a retrospective study

Weiss

Beck-Fruchter

Golan

et al. 2016

Reprod Biol Endocrinol

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BackgroundIn-vitro fertilization is a known risk factor for ectopic pregnancies. We sought to establish the risk factors for ectopic pregnancy in GnRH antagonist cycles examining patient and stimulation parameters with an emphasis on ovulation trigger.MethodsWe conducted a retrospective, cohort study of 343 patients undergoing 380 assisted reproductive technology (ART) cycles with the GnRH antagonist protocol and achieving a clinical pregnancy from November 2010 through December 2015.ResultsSignificant risk factors for ectopic pregnancy in the univariate analysis included prior Cesarean section (CS), endometriosis, mechanical factor infertility, longer stimulation, elevated estradiol and progesterone levels, GnRH agonist trigger, higher number of oocytes aspirated, and insemination technique. Independent risk factors for ectopic pregnancy in the multivariate analysis included GnRH agonist trigger, higher number of oocytes aspirated, insemination technique, and prior Cesarean section.ConclusionExcessive ovarian response, IVF (as opposed to ICSI), prior Cesarean section and GnRH agonist trigger were found to be independent risk factors for ectopic pregnancy. Caution should be exercised before incorporating the GnRH agonist trigger for indications other than preventing OHSS. When excessive ovarian response leads to utilization of GnRH agonist trigger, strategies for preventing ectopic pregnancy, such as a freeze all policy or blastocyst transfer, should be considered. Further studies should elucidate whether adjusting the luteal support can reduce the ectopic pregnancy risk.

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“…Some studies considered that mature oocyte rate had no significant relationship with basic parameters [14]. In our research, we found that there were some basic parameters associating with mature oocyte rate.…”

Section: Comparisons Of Results Between Ours and Previous Studiesmentioning

confidence: 47%

“…The early research found the proper trigger-OPU interval in patients stimulated with clomiphene citrate (CC) or hMG was 32-36 h [2,29,30]. After that, lots of research explored whether oocytes should be retrieved earlier or later in the gonadotropin-releasing hormone analog (GnRHa) combined with hMG protocol [1,5,9,13,14,31,32]. For the different GnRHa protocols which may bring the distinct extent of pituitary suppression and need diverse in vivo maturation time before oocyte retrieving, the only related research is one meeting abstract [16], which found the long protocol, flare-up, and antagonist protocols had their discrepant optimal time for oocyte retrieval in terms of egg maturation, fertilization, implantation, and clinical pregnancy rates.…”

Section: Comparisons Of Results Between Ours and Previous Studiesmentioning

confidence: 99%

“…Some studies have found that longer OPU time did not lead to more mature oocytes or better clinical results [4][5][6][7][8], whereas other studies have found that longer OPU time may produce more mature oocytes [1,9,10], higher fertilization rate [11], better blastocyst development [12], more goodquality embryos, and higher ongoing pregnant rate [13]. There were also some studies which showed prolonging the interval between human chorionic gonadotropin (hCG) priming and oocyte retrieval could only increase the proportion of MII oocytes, rather than the pregnancy rates [14,15]. Therefore, most research focused on whether doctors should delay the OPU time in the specific controlled ovarian hyperstimulation (COH) protocol, such as the gonadotropinreleasing hormone analog (GnRHa) protocol.…”

Section: Introductionmentioning

confidence: 99%

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The ovulation trigger–OPU time interval of different ovarian protocols in ART: a retrospective study

Shen

Long

Guo

et al. 2020

Arch Gynecol Obstet

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Purpose To explore the trends of oocyte and pregnancy outcomes over the ovulation trigger-OPU (oocyte pickup) time interval in four mainly used COH protocols. Methods This retrospective study was conducted between January 2013 and July 2018. The IVF/ICSI cycles of the patients with normal ovarian reserve were included. The number of total patients was 4673, which consisted of long agonist protocol (n = 819), short agonist protocol (n = 1703), mild stimulation protocol (n = 1627), and GnRH antagonist protocol (n = 524). The primary outcome was mature oocyte rate. Results The ovulation trigger-OPU time interval and COH protocol were related to cycles with > 80% MII oocytes. Four protocols showed apparently different trends of retrieved oocyte rate and mature oocyte rate over the ovulation trigger-OPU time interval, and the long agonist protocol had the most delayed time interval than other three COH protocols in retrieving more than 60% oocytes (35.

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Lag time from ovulation trigger to oocyte aspiration and oocyte maturity in assisted reproductive technology cycles: a retrospective study

Cited by 25 publications

References 22 publications

A Higher Estradiol Rise After Dual Trigger in Progestin-Primed Ovarian Stimulation Is Associated With a Lower Oocyte and Mature Oocyte Yield in Normal Responders

A Higher Estradiol Rise After Dual Trigger in Progestin-Primed Ovarian Stimulation Is Associated With a Lower Oocyte and Mature Oocyte Yield in Normal Responders

Ectopic pregnancy risk factors for ART patients undergoing the GnRH antagonist protocol: a retrospective study

The ovulation trigger–OPU time interval of different ovarian protocols in ART: a retrospective study

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