Cumulative live birth rates after GnRH-agonist triggering of final oocyte maturation in patients at risk of OHSS: a prospective, clinical cohort study.
OBJECTIVE
To prospectively study the incidence of OHSS, live birth likelihood and neonatal outcome after GnRH-agonist triggering of final oocyte maturation and vitrification of all pronucleate (2PN) oocytes for later frozen-thawed embryo transfer (FRET) in an OHSS-risk population.


METHODS
Prospective, clinical cohort study (12/2004-5/2009). Forty patients undergoing ovarian stimulation in a GnRH-antagonist protocol and at risk of developing severe OHSS underwent triggering with 0.2mg triptorelin and elective vitrification of all 2PN-oocytes for later frozen-thawed embryo transfer.


RESULTS
The incidence of OHSS was 0% (0/40; 95% confidence interval: 0.0-6.4%). Thirty-nine patients underwent 87 FRETs (mean number of FRETs per patient: 2.2+/-1.6; range: 1-7). The cumulative live birth rate per patient was 35.0% (14/40; 95% confidence interval: 23.9-48.0%). Mean time-to-conception resulting in live birth after agonist triggering was 24.2 (+/-17.1; range: 9-67) weeks. Nine healthy singletons and five twins were born.


CONCLUSIONS
A treatment algorithm combining agonist trigger with vitrification of all 2PN-oocytes is feasible and safe, and provides patients with a good cumulative chance of live birth.
Griesinger
Georg
G
Department of Obstetrics and Gynecology, University Clinic of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany. Georg.Griesinger@frauenklinik.uni-luebeck.de
Berndt
Henriette
H
Schultz
Laura
L
Depenbusch
Marion
M
Schultze-Mosgau
Askan
A
D000328:Adult; D001723:Birth Rate; D015331:Cohort Studies; D015925:Cryopreservation; D004624:Embryo Transfer; D005260:Female; D006801:Humans; D054315:Oocyte Retrieval / Q000379:methods; D009865:Oocytes / Q000187:drug effects / Q000502:physiology*; D016471:Ovarian Hyperstimulation Syndrome / Q000188:drug therapy / Q000517:prevention & control*; D011446:Prospective Studies; D017329:Triptorelin Pamoate / Q000627:therapeutic use*
D017329:Triptorelin Pamoate