title: Failure of GnRH agonist-triggered oocyte maturation: its cause and management.
abstract: OBJECTIVE
  In the present study we investigated the cause of GnRHa's failure to trigger oocyte maturation and present an effective rescue protocol for use when failure occurs.
  
  
  METHODS
  Case reports.
  
  
  METHODS
  One in vitro fertilization (IVF) center.
  
  
  METHODS
  Eight cases of failure of GnRH agonist (GnRHa)-triggered oocyte maturation and one case of GnRHa successfully triggered oocyte maturation, despite a weak response in the LH-RH test.
  
  
  METHODS
  All cases were successfully rescued by re-triggering maturation using HCG, with seven of the eight patients achieving ongoing pregnancy and successful delivery.
  
  
  RESULTS
  In three patients the cause of the oocyte maturation failure was likely temporal or continuous severe down-regulation of the hypothalamus-pituitary-axis, the cause was unknown in the other five patients.
  
  
  CONCLUSIONS
  In cases where GnRHa fails to trigger oocyte maturation, a rescue protocol entailing re-triggering with HCG can produce successful outcomes.
authors.affiliation: Asada Ladies Clinic, RENAK 5F, Matsushincho 1-4, Kasugai, Aichi, 486-0931, Japan. y_asada@ivf-asada.jp
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Asada
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Itoi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Honnma
authors.forename: Shuji
authors.initials: S
authors.lastname: Takiguchi
authors.forename: Noritaka
authors.initials: N
authors.lastname: Fukunaga
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Hashiba
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Baba
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Endo
mesh_terms: D000328:Adult; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D009865:Oocytes; D010062:Ovulation Induction; D011247:Pregnancy
chemical_list: D007987:Gonadotropin-Releasing Hormone