title: Gonadotropin-releasing hormone agonist trigger in oocyte donors co-treated with a gonadotropin-releasing hormone antagonist: a dose-finding study.
abstract: OBJECTIVE
  To determine the optimal GnRH agonist dose for triggering of oocyte maturation in oocyte donors.
  
  
  METHODS
  Single-center, randomized, parallel, investigator-blinded trial.
  
  
  METHODS
  IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam.
  
  
  METHODS
  One hundred sixty-five oocyte donors (aged 18-35 years, body mass index [BMI] <28 kg/m(2), antimüllerian hormone level >1.25 ng/mL, and antral follicle count ≥6).
  
  
  METHODS
  Ovulation trigger with 0.2, 0.3, or 0.4 mg triptorelin in a GnRH antagonist cycle.
  
  
  METHODS
  The primary end point was number of metaphase II oocytes. Secondary end points were fertilization and cleavage rates, number of embryos and top-quality embryos, steroid levels, ovarian volume, and ongoing pregnancy rate (PR) in recipients.
  
  
  RESULTS
  There were no significant differences between the triptorelin 0.2, 0.3, and 0.4 mg trigger groups with respect to number of metaphase II oocytes (16.0 ± 8.5, 15.9 ± 7.8, and 14.7 ± 8.4, respectively), embryos (13.2 ± 7.8, 11.7 ± 6.9, 11.8 ± 7.0), and number of top-quality embryos (3.8 ± 2.9, 3.6 ± 3.0, 4.1 ± 3.0). Luteinizing hormone levels at 24 hours and 36 hours after trigger was significantly higher with triptorelin 0.4 mg versus 0.2 mg and 0.3 mg (9.8 ± 7.1 IU/L vs. 7.3 ± 4.1 IU/L and 7.2 ± 3.7 IU/L, respectively; 4.6 ± 3.2 IU/L vs. 3.2 ± 2.3 IU/L and 3.3 ± 2.1 IU/L, respectively. Progesterone level at oocyte pick-up +6 days was significantly higher in the 0.4-mg group (2.2 ± 3.7 ng/ml) versus 0.2 mg (1.1 ± 1.0 ng/ml) and 0.3 mg (1.2 ± 1.6 ng/ml). One patient developed early-onset severe ovarian hyperstimulation syndrome (OHSS).
  
  
  CONCLUSIONS
  No significant differences between triptorelin doses of 0.2, 0.3, and 0.4 mg used for ovulation trigger in oocyte donors were seen with regard to the number of mature oocytes and top-quality embryos.
  
  
  BACKGROUND
  NCT02208986.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Medicine and Pharmacy HCMC, Ho Chi Minh City, Vietnam; IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam. Electronic address: drlan@yahoo.com.vn.
authors.forename: Thi Ngoc Lan
authors.initials: TN
authors.lastname: Vuong
authors.affiliation: IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam; Research Center for Genetics and Reproductive Health (CGRH), School of Medicine, Vietnam National University HCMC, Ho Chi Minh City, Vietnam.
authors.forename: Manh Tuong
authors.initials: MT
authors.lastname: Ho
authors.affiliation: National Hospital of Can Tho, Ho Chi Minh City, Vietnam; Ton Duc Thang University, Ho Chi Minh City, Vietnam.
authors.forename: Tan Duc
authors.initials: TD
authors.lastname: Ha
authors.affiliation: IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam.
authors.forename: Huy Tuan
authors.initials: HT
authors.lastname: Phung
authors.affiliation: IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam.
authors.forename: Gia Bao
authors.initials: GB
authors.lastname: Huynh
authors.affiliation: The Fertility Clinic, Skive Regional Hospital, Aarhus, Denmark; Faculty of Health, Aarhus University and Faculty of Health, University of Southern Denmark, Aarhus, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Humaidan
mesh_terms: D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood; D054796:Drug Dosage Calculations; D004624:Embryo Transfer; D005260:Female; D005298:Fertility; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000009:adverse effects / Q000819:agonists* / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors*; D006727:Hormone Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D007986:Luteinizing Hormone / Q000097:blood; D008677:Metaphase / Q000187:drug effects; D018587:Oocyte Donation; D009865:Oocytes / Q000166:cytology / Q000187:drug effects* / Q000378:metabolism; D010060:Ovulation / Q000187:drug effects; D010062:Ovulation Induction / Q000009:adverse effects / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000097:blood; D016896:Treatment Outcome; D017329:Triptorelin Pamoate / Q000008:administration & dosage* / Q000009:adverse effects; D014744:Vietnam; D055815:Young Adult
chemical_list: D005300:Fertility Agents, Female; D006727:Hormone Antagonists; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D054304:Anti-Mullerian Hormone; D007986:Luteinizing Hormone; C061018:ganirelix
keywords: In vitro fertilization; dose-finding; gonadotropin-releasing hormone agonist trigger; oocyte donor; triptorelin