Gonadotropin-releasing hormone agonist to induce final oocyte maturation prevents the development of ovarian hyperstimulation syndrome in high-risk patients and leads to improved clinical outcomes compared with coasting.
Ninety-four women undergoing IVF with peak E2 level>4000 pg/mL received leuprolide acetate (LA) trigger (LA trigger group) or had gonadotropins withheld for one or more days (coasting group) followed by hCG trigger, unless cycle cancellation occurred. There were no cases of ovarian hyperstimulation syndrome in either group, and the LA trigger group had significantly more oocytes retrieved (26.9+/-9.5 vs. 17.7+/-9.3) P<0.001, more normally fertilized oocytes (15.0+/-7.8 vs. 10.3+/-6.3) P=0.01, and higher clinical and ongoing pregnancy rates than the coasting group (52.5% vs. 27.2%; 49.2% vs. 24.2%, P=0.02 for both comparisons, respectively).
DiLuigi
Andrea J
AJ
The Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, University of Connecticut Health Center, Farmington, Connecticut 06030-6224, USA. diluigi@uchc.edu
Engmann
Lawrence
L
Schmidt
David W
DW
Maier
Donald B
DB
Nulsen
John C
JC
Benadiva
Claudio A
CA
D000328:Adult; D004334:Drug Administration Schedule; D004958:Estradiol / Q000097:blood; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D016729:Leuprolide / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology*; D009865:Oocytes / Q000187:drug effects* / Q000502:physiology; D009866:Oogenesis / Q000187:drug effects; D016471:Ovarian Hyperstimulation Syndrome / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D028761:Withholding Treatment
D005300:Fertility Agents, Female; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D016729:Leuprolide