title: Major drawbacks and additional benefits of agonist trigger--not ovarian hyperstimulation syndrome related.
abstract: The GnRH agonist trigger alters traditional IVF paradigms when compared with hCG-only triggers. The agonist trigger induces rapid luteolysis and therefore separates the oocyte maturation aspect of LH from the luteal support previously afforded by lingering hCG. This might allow customized and more optimal luteal support. The agonist trigger option also allows continued stimulation and subsequent trigger of high responders with reasonable safety, potentially leading to retrievals of larger cohorts of mature oocytes. It may also reduce the number of retrievals needed to achieve a large family. The agonist trigger might alter other paradigms as well, such as making oocyte donation more efficient per stimulation by virtually eliminating follicular-phase cycle cancellation, coasting, and premature triggering. There are both corresponding potential benefits and drawbacks of using the agonist trigger and the shifting paradigms it allows.
authors.affiliation: Fertility Center of Las Vegas, Las Vegas, Nevada; Department of Obstetrics and Gynecology, University of Nevada School of Medicine, Las Vegas, Nevada. Electronic address: bsshapiro@aol.com.
authors.forename: Bruce S
authors.initials: BS
authors.lastname: Shapiro
authors.affiliation: Laboratory of Reproductive Biology, University Hospital of Copenhagen, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Claus Yding
authors.initials: CY
authors.lastname: Andersen
mesh_terms: D005260:Female; D005300:Fertility Agents, Female / Q000009:adverse effects* / Q000494:pharmacology; D005307:Fertilization in Vitro / Q000379:methods; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D008183:Luteal Phase / Q000187:drug effects / Q000502:physiology; D018587:Oocyte Donation / Q000379:methods; D009866:Oogenesis / Q000187:drug effects / Q000502:physiology; D016471:Ovarian Hyperstimulation Syndrome; D010062:Ovulation Induction / Q000009:adverse effects* / Q000379:methods; D011247:Pregnancy
chemical_list: D005300:Fertility Agents, Female; D007987:Gonadotropin-Releasing Hormone
keywords: GnRH agonist; Ovarian stimulation; human chorionic gonadotropin; in vitro fertilization