Retrospective comparison of GnRH agonist trigger with HCG trigger in GnRH antagonist cycles in anticipated high-responders

Datta, Adrija; Eapen, Abey; Birch, Heidi; Kurinchi-Selvan, A.; Lockwood, Gillian

doi:10.1016/j.rbmo.2014.08.006

Cited by 12 publications

(23 citation statements)

References 37 publications

(54 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of note, none of the patients who developed OHSS had a diagnosis of PCOS. In support of our findings, other investigators have reported that administration of low doses of hCG prior to or at the time of oocyte retrieval is associated with even higher rates of OHSS (16-21 %) than were detected in our study [26,27,30,36].…”

Section: Discussionsupporting

confidence: 92%

“…Despite this success, concerns remain regarding the subgroups of patients who respond inadequately to a GnRHa trigger with decreased oocyte yield, in both quantity and quality, and subsequently failed IVF cycles. Although initially low-dose hCG (1000-2500 IU) was used after GnRHa trigger for enhanced luteal support [20][21][22][23][24][25][26][27], two studies described the co-administration of low-dose hCG (1000-2500 IU) at the time of GnRHa trigger for oocyte maturation (called dual trigger) [28,29]. These studies did not find that dual trigger was associated with an increase in the number of oocytes retrieved and did not examine oocyte maturation rates.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

GnRH agonist with low-dose hCG (dual trigger) is associated with higher risk of severe ovarian hyperstimulation syndrome compared to GnRH agonist alone

O’Neill

Senapati

Maina

et al. 2016

J Assist Reprod Genet

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

GnRH agonist with low-dose hCG (dual trigger) is associated with higher risk of severe ovarian hyperstimulation syndrome compared to GnRH agonist alone

O’Neill

Senapati

Maina

et al. 2016

J Assist Reprod Genet

View full text Add to dashboard Cite

show abstract

“…The use of GnRHa for inducing oocyte maturation in individualized ovarian stimulation cycles utilizing GnRH antagonist for pituitary suppression has proved to be a very effective measure in prevention of risk of OHSS. 5 GnRHa trigger has been a tremendous revolutionary tool in history of development of assisted reproductive technology leading to a new era of administering it as a sole method in having OHSS-free clinic. 6 This concept came from the short half-life of endogenous luteinizing hormone surge which results in early luteolysis of corpus luteum.…”

Section: Introductionmentioning

confidence: 99%

Prediction of efficacy of gonadotropin releasing hormone agonist trigger for final oocyte maturation through post-trigger 12-hour luteinizing hormone, follicle stimulating hormone and progesterone levels in COS: a prospective study

Agarwal

Krishna

Pranesh

et al. 2019

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

HCG binds to LH receptor causing follicular maturation, luteinization and ovulation. It has 6-7 times increased biological activity with half life persisting upto 5-6 days. 3 ABSTRACT Background: Circulating levels of luteinizing hormone (LH), follicle stimulating hormone (FSH) and progesterone (P4) in serum after administration of gonadotropin releasing hormone agonist (GnRHa) trigger for final oocyte maturation are found to be predictive of oocyte maturity. This prospective study was conducted at a tertiary care centre to evaluate relationship between serum LH, FSH and P4 levels at 12-h post-trigger and oocyte maturity rate and to predict which hormone has maximum sensitivity and specificity for appropriate oocyte maturation. Methods: Women at risk of ovarian hyper-stimulation syndrome who underwent either autologous or donor IVF cycle treated with flexible GnRH antagonist protocol were taken as participants of the study. GnRHa as trigger for final oocyte maturation was given. After 12 hours of agonist trigger, blood sample was drawn to assess LH, FSH and P4 levels in serum. Continuous variables were expressed as mean±SD. Independent sample t test was used for continuous variables which were normally distributed and Mann-Whitney U test for data not normally distributed. Main outcome measures were number of oocytes retrieved, oocyte maturity rate, fertilization rate, cleavage rate and grade of embryos. Results: There was a statistically significant reduction in number of retrieved oocytes, maturity rate, fertilization rate and grade 1 embryos with a concentration of serum LH and P4 less than the cut off value (p < 0.05). Conclusions: Serum LH and P4 level less than the cut off value at 12-hour post-trigger with GnRHa is associated with a dramatically less oocyte maturity rate and fertilization rate.

show abstract

“…In contrast to poor responders, high responders are characterized by an exaggerated response accompanied with a higher risk for ovarian hyperstimulation syndrome (OHSS) [Datta et al 2014;Huber et al 2013]. OHSS is characterized by the release of excessive vasoactive factors (especially vascular endothelial growth factor -VEGF), increased vascular permeability, and fluid shifts out of the intravascular space, resulting in excessive extravascular third spacing [Gomez et al 2010;Papanikolaou et al 2010].…”

Section: Introductionmentioning

confidence: 99%

“…In spite of its importance and relevance for ART, the literature regarding high responders is characterized by heterogeneous classification methodology [Casano et al 2012;Datta et al 2014]. As shown in Table 1, variable criteria in the literature relate to: (1) risk factors for high ovarian response, (2) risk factors for OHSS, as well as (3) the definition of a high ovarian response.…”

Section: Introductionmentioning

confidence: 99%

The continuum of high ovarian response: a rational approach to the management of high responder patient subgroups

Gat

Shlush

Quach

et al. 2015

Systems Biology in Reproductive Medicine

View full text Add to dashboard Cite

Ovarian follicular responsiveness to controlled ovarian hyperstimulation (COH) with gonadotropins is extremely variable between individual patients, and even from cycle to cycle for the same patient. High responder patients are characterized by an exaggerated response to gonadotropin administration, accompanied by a higher risk for ovarian hyperstimulation syndrome (OHSS). In spite of its importance, the literature regarding high responders is characterized by heterogeneous classification methodologies. A clear separation should be drawn between risk factors for a high ovarian response and the actual response exhibited by a patient to stimulation. Similarly, it is important to distinguish between high ovarian response and development of clinically significant OHSS. In this article we: (1) review recent publications pertaining to the identification and clinical management of high responders, (2) propose an integrated clinical model to differentiate sub-groups within this population based on this review, and (3) suggest specific protocols for each sub-group. The model is based on a chronological patient assessment in an effort to target treatment based on the specific clinical circumstances. It is our hope that the algorithm we have developed will assist clinicians to supply targeted and precise treatments in order to achieve a favorable reproductive outcome with minimum complications for each patient.

show abstract

Retrospective comparison of GnRH agonist trigger with HCG trigger in GnRH antagonist cycles in anticipated high-responders

Cited by 12 publications

References 37 publications

GnRH agonist with low-dose hCG (dual trigger) is associated with higher risk of severe ovarian hyperstimulation syndrome compared to GnRH agonist alone

GnRH agonist with low-dose hCG (dual trigger) is associated with higher risk of severe ovarian hyperstimulation syndrome compared to GnRH agonist alone

Prediction of efficacy of gonadotropin releasing hormone agonist trigger for final oocyte maturation through post-trigger 12-hour luteinizing hormone, follicle stimulating hormone and progesterone levels in COS: a prospective study

The continuum of high ovarian response: a rational approach to the management of high responder patient subgroups

Contact Info

Product

Resources

About