title: [GnRH agonist triggering in IVF and luteal phase support in women at risk of ovarian hyperstimulation syndrome].
abstract: OBJECTIVE
  To evaluate the efficacy and safety of ovulation triggering by agonists in antagonists IVF cycles with fresh embryo transfer in modulating low HCG dose for luteal phase support in patients at risk of ovarian hyperstimulation syndrome (OHSS).
  
  
  METHODS
  In an observational study from September 2011 to March 2013, we triggered with agonist 107 cycles with OHSS risk, we initially triggered 39 cycles with 2 doses of Triptorelin 0.1 mg. Injection of 1500 IU HCG was performed one hour after the pick up and a second injection of 1500 IU was made 5 days later (group 1) combined with 400 mg of natural progesterone vaginally. In the following 68 cycles we removed the second HCG injection and increased to 600 mg vaginal progesterone associated with E2 4 mg orally (group 2).
  
  
  RESULTS
  Group 1: the ongoing pregnancy rate and birth rate in fresh cycle is respectively 37.1% and 34.3% and the cumulative ongoing pregnancy rate and birth rate per patient is 43.6% and 41%. We recorded three late onset OHSS in pregnant women. Group 2: ongoing pregnancy rate in fresh cycle is 39.6%, the current cumulative ongoing pregnancy rate per patient was 45.6%. We observed a case of early onset OHSS.
  
  
  CONCLUSIONS
  Triggering with agonist and administering an injection of 1500 IU of HCG the day of the pick up appears to be effective in women at risk of OHSS. The exclusion of all OHSS is still not reached. The search for the best protocol and its indications should continue.
authors: Centre AMP, clinique mutualiste La Sagesse, 3, place Saint-Guénolé, 35000 Rennes, France. anne.guivarch@orange.fr
authors: A
authors: A
authors: Guivarc'h-Levêque
authors: F
authors: F
authors: Jaffré
authors: L
authors: L
authors: Homer
authors: L
authors: L
authors: Moy
authors: G
authors: G
authors: Priou
authors: D
authors: D
authors: Colleu
authors: I
authors: I
authors: Denis
authors: P
authors: P
authors: Arvis
mesh_terms: D000282:Administration, Intravaginal; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D008183:Luteal Phase; D008186:Luteolytic Agents / Q000008:administration & dosage; D016471:Ovarian Hyperstimulation Syndrome / Q000517:prevention & control*; D010062:Ovulation Induction / Q000009:adverse effects / Q000379:methods*; D011247:Pregnancy; D011374:Progesterone / Q000008:administration & dosage; D012307:Risk Factors; D017329:Triptorelin Pamoate / Q000008:administration & dosage
chemical_list: D006063:Chorionic Gonadotropin; D008186:Luteolytic Agents; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone
keywords: Agonistes du GnRH; Antagonistes du GnRH; Déclenchement ovulation; GnRH agonist; GnRH antagonist; Hyperstimulation ovarienne; Luteal phase support; Ovarian hyperstimulation syndrome; Ovulation triggering; Soutien phase lutéale