title: Basic understanding of gonadotropin-releasing hormone-agonist triggering.
abstract: A single bolus of human chorionic gonadotropin (hCG) at midcycle has been the gold standard for triggering final oocyte maturation and ovulation in assisted reproductive technology cycles. More recently, gonadotropin-releasing hormone (GnRH)-agonist (GnRH-a) triggering has been introduced. The GnRH-a trigger may allow a more physiologic surge of both luteinizing hormone (LH) and follicle-stimulating hormone, although whether the combined surge will result in improved oocyte and embryo quality remains to be seen. However, the short duration of the LH surge with the GnRH-a trigger (approximately 34 hours) has been shown to be beneficial for preventing ovarian hyperstimulation syndrome in GnRH antagonist in vitro fertilization (IVF) cycles when compared with the prolonged elevation of hCG (≥6 days) after exposure to an hCG bolus. This review discusses the physiologic basis for the use of a GnRH-a trigger in IVF cycles.
authors.affiliation: Division of Reproductive Sciences, University of Toronto, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, and Toronto Centre for Advanced Reproductive Technology Fertility Partners, Toronto, Ontario, Canada. Electronic address: casper@lunenfeld.ca.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Casper
mesh_terms: D006063:Chorionic Gonadotropin / Q000502:physiology / Q000627:therapeutic use; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005307:Fertilization in Vitro / Q000379:methods; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D016471:Ovarian Hyperstimulation Syndrome / Q000209:etiology; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate
chemical_list: D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D007987:Gonadotropin-Releasing Hormone
keywords: Gonadotropin-releasing hormone (GnRH) agonist; human chorionic gonadotropin (hCG); in vitro fertilization (IVF); ovarian hyperstimulation syndrome (OHSS); ovulation induction