Triggering of final oocyte maturation with gonadotropin-releasing hormone agonist or human chorionic gonadotropin. Live birth after frozen-thawed embryo replacement cycles.
OBJECTIVE
To report the outcome of frozen-thawed embryo replacement cycles after GnRH-agonist triggering of final oocyte maturation in the collecting cycle with GnRH-antagonist.


METHODS
Prospective, observational, multicentric clinical study.


METHODS
Tertiary university-affiliated IVF centers.


METHODS
Patients under observation previously had been recruited into two concurrently performed, independent, randomized controlled trials (comparing hCG with GnRH-agonist for triggering final oocyte maturation in GnRH-antagonist multiple-dose protocols in normal responder patients) encompassing a total of 228 participants. Surplus embryos or oocytes at the pronuclear stage were cryopreserved in 53 patients after hCG administration and 32 patients after GnRH-agonist administration on the basis of patient choice, pronuclear/embryo availability, and local laws.


METHODS
Transfer of frozen-thawed embryos.


METHODS
Live birth rate.


RESULTS
Thirty-one and 23 patients after administration of hCG and GnRH-agonist, respectively, started a frozen-embryo replacement cycle by September 2005, with 25 and 16 patients eventually undergoing at least one frozen-thawed ET. Live birth rate per ET was 18.5% (95% confidence interval [CI], 8.2-36.7) and 30.0% (95% CI, 14.5-51.9) after hCG and GnRH-agonist triggering, respectively. Cumulative live birth rate per patient starting a frozen-embryo replacement cycle was 16.1% (95% CI, 7.1-32.6) and 26.1% (95% CI, 12.5-46.5) for hCG and GnRH-agonist, respectively.


CONCLUSIONS
The likelihood of live birth in frozen-embryo replacement cycles after GnRH-agonist triggering of final oocyte maturation does not appear to be impaired.
Griesinger
Georg
G
Department of Obstetrics and Gynaecology, University Clinic of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany. georg.griesinger@frauenklinik.uni-luebeck.de <georg.griesinger@frauenklinik.uni-luebeck.de>
Kolibianakis
E M
EM
Papanikolaou
E G
EG
Diedrich
K
K
Van Steirteghem
A
A
Devroey
P
P
Ejdrup Bredkjaer
Helle
H
Humaidan
Peter
P
D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D015925:Cryopreservation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D009865:Oocytes / Q000187:drug effects / Q000502:physiology*; D010062:Ovulation Induction; D018579:Patient Selection; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies
D006063:Chorionic Gonadotropin; D007987:Gonadotropin-Releasing Hormone