title: Is the GnRH Antagonist Protocol Effective at Preventing OHSS for Potentially High Responders Undergoing IVF/ICSI?
abstract: OBJECTIVE
  To determine if the GnRH antagonist protocol is effective in preventing ovarian hyperstimulation syndrome (OHSS) in potentially high responders.
  
  
  METHODS
  A total of 660 IVF-ET/ICSI cycles were retrospectively identified. The inclusion criterion was age ≤ 30 years. Cycles were divided into two groups: a GnRHa group and a GnRHant group. In the GnRHa group, the patients received one single injection of 1.0mg-1.3mg Triptorelin in previous mid-luteal phase. In the GnRHant group, a daily dose of 0.25 mg Cetrotide was initiated when a lead follicle obtained a mean diameter of 14 mm, continued up until the day of hCG administration. The duration of stimulation, total dose of Gn, implantation rate, pregnancy rate, and OHSS rate were compared.
  
  
  RESULTS
  The duration of stimulation, E2 level on hCG day, numbers of oocytes retrieved, MII oocytes, and high-quality embryos in the GnRHa group were all significantly more than those in the GnRHant group. In the GnRHa group, 83.53% of cancelled fresh-transferred cycles were cancelled because of high risk of OHSS, which was significantly higher than that in the GnRHant group (43.55%, P<0.05). The incidence of OHSS in the GnRHa group was slightly higher than that in the GnRHant group. The implantation and clinical pregnancy rates in the GnRHa group were significantly higher than those in the GnRHant group (37.36% VS 19.25%, 62.78% VS 31.06%; P<0.05).
  
  
  CONCLUSIONS
  Our study demonstrated that for potentially high responders, the GnRHant protocol can, to some extent, lower the cancellation and incidence rates of OHSS. The GnRHa protocol was superior to the GnRHant protocol in terms of implantation and clinical pregnancy rates.
authors.affiliation: Center for Reproductive Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Weijie
authors.initials: W
authors.lastname: Xing
authors.affiliation: Center for Reproductive Medicine, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Lin
authors.affiliation: Center for Reproductive Medicine, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Li
authors.affiliation: Center for Reproductive Medicine, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Dongzi
authors.initials: D
authors.lastname: Yang
authors.affiliation: Center for Reproductive Medicine, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Wenjun
authors.initials: W
authors.lastname: Wang
authors.affiliation: Center for Reproductive Medicine, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Qingxue
authors.initials: Q
authors.lastname: Zhang
mesh_terms: D004334:Drug Administration Schedule; D010064:Embryo Implantation / Q000187:drug effects; D005260:Female; D005307:Fertilization in Vitro / Q000187:drug effects*; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology; D006727:Hormone Antagonists / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D006801:Humans; D015994:Incidence; D009865:Oocytes / Q000187:drug effects; D016471:Ovarian Hyperstimulation Syndrome / Q000453:epidemiology / Q000517:prevention & control*; D011247:Pregnancy; D018873:Pregnancy Rate / Q000639:trends; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000187:drug effects*; D017329:Triptorelin Pamoate / Q000008:administration & dosage / Q000494:pharmacology
chemical_list: D006727:Hormone Antagonists; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; C062876:cetrorelix