title: Impact of GnRH agonist triggering and intensive luteal steroid support on live-birth rates and ovarian hyperstimulation syndrome: a retrospective cohort study.
abstract: BACKGROUND
  Conventional luteal support packages are inadequate to facilitate a fresh transfer after GnRH agonist (GnRHa) trigger in patients at high risk of developing ovarian hyperstimulation syndrome (OHSS). By providing intensive luteal-phase support with oestradiol and progesterone satisfactory implantation rates can be sustained. The objective of this study was to assess the live-birth rate and incidence of OHSS after GnRHa trigger and intensive luteal steroid support compared to traditional hCG trigger and conventional luteal support in OHSS high risk Asian patients.
  
  
  METHODS
  We conducted a retrospective cohort study of 363 women exposed to GnRHa triggering with intensive luteal support compared with 257 women exposed to conventional hCG triggering. Women at risk of OHSS were defined by ovarian response ≥15 follicles ≥12 mm on the day of the trigger.
  
  
  RESULTS
  Live-birth rates were similar in both groups GnRHa vs hCG; 29.8% vs 29.2% (p = 0.69). One late onset severe OHSS case was observed in the GnRHa trigger group (0.3%) compared to 18 cases (7%) after hCG trigger.
  
  
  CONCLUSIONS
  GnRHa trigger combined with intensive luteal steroid support in this group of OHSS high risk Asian patients can facilitate fresh embryo transfer, however, in contrast to previous reports the occurrence of late onset OHSS was not completely eliminated.
authors.affiliation: Maternal and Reproductive Medicine, School of Medicine, University of Glasgow, Glasgow, UK. stamatina.iliodromiti@glasgow.ac.uk.
authors.forename: Stamatina
authors.initials: S
authors.lastname: Iliodromiti
authors.forename: Vuong Thi Ngoc
authors.initials: VT
authors.lastname: Lan
authors.forename: Ho Manh
authors.initials: HM
authors.lastname: Tuong
authors.forename: Phung Huy
authors.initials: PH
authors.lastname: Tuan
authors.forename: Peter
authors.initials: P
authors.lastname: Humaidan
authors.forename: Scott M
authors.initials: SM
authors.lastname: Nelson