The impact of using gonadotropin-releasing hormone agonist for triggering final oocyte maturation in antagonist-treated intracytoplasmic sperm injection cycles on women at high risk of developing ovarian hyperstimulation syndrome. Issue 3 (August 2016)

• Record Type: Journal Article
• Authors: Elnassery, Noura S.; Abuhamila, Fouad A.
• Is Part Of: Evidence based women's health journal. Volume 6:Issue 3(2016)
• Publication Date: 2016-08
• Subjects: gonadotropin-releasing hormone agonist triggering -- gonadotropin-releasing hormone antagonist protocol -- high responder -- luteal phase support -- ovarian hyperstimulation syndrome rate; Women -- Diseases -- Periodicals; Women's Health -- Periodicals; 616.008205
• DOI: 10.1097/01.EBX.0000482801.97372.5c
• Languages: English
• ISSNs: 2090-7265

Abstract

Abstract : Objective: The study aimed to assess the impact of gonadotropin-releasing hormone (GnRH) agonist trigger in GnRH antagonist intracytoplasmic sperm injection cycles. Study design: It was a retrospective, cohort study. Patients and methods: Participants were assigned to two groups: group 1 included 257 women at risk of developing severe ovarian hyperstimulation syndrome (OHSS), and group 2 included 525 women with a lower risk of developing severe OHSS. All participants were subjected to the GnRH antagonist protocol triggered with GnRH agonist in group 1 and with human chorionic gonadotropin in group 2. Patients were then subdivided into those who transferred their embryos on day 3 and those who transferred their embryos on day 5. Results: The main outcomes were pregnancy rate, clinical pregnancy rate, implantation rate, and OHSS rate in each group. Group 1 had higher number of MII oocyte collection, higher number of frozen embryos, and higher number of cycles with available embryos for cryopreservation. A lower pregnancy rate, clinical pregnancy rate, and implantation rate were achieved in group 1, with significantly less moderate/severe OHSS, especially in patients who transferred their embryos on day 5. Conclusion: GnRH agonist trigger should be the protocol of choice as regards its benefit in preventing OHSS, with special rescue measures for the luteal phase.