title: Ovulation induction and luteal support with GnRH agonist in patients at high risk for hyperstimulation syndrome.
abstract: The aim of this study was to compare GnRHa trigger and luteal addition of triptorelin to hCG trigger for final oocyte maturation in women at high risk for OHSS undergoing IVF. A total of 423 patients were divided in two groups both stimulated using antagonist short protocol. Gonadotropins 75-150 UI/day were started on day 2-5, GnRH antagonist was added when the lead follicle was >14 mm and the final trigger was obtained with hCG 250 µg or triptorelin 0.2 mg. The luteal phase was supported with progesterone alone in the hCG group, with progesterone plus triptorelin 0.1 every other day from embryo transfer in the triptorelin group. In the triptorelin group we did neither have to suspend any embryo transfer, nor we have any early clinical OHSS. In the control group, 13 patients were suspended due to symptomatic high risk for OHSS and two patients developed a clinically significant OHSS. No statistically significant difference was observed in terms of clinical and ongoing pregnancy rates and implantation rates. Our results indicate that a protocol including GnRHa as trigger and an intensive luteal phase supported with GnRHa is safer than a standard antagonist protocol using hCG as trigger. It displays similar results, therefore it can be used as the first choice in patients at high risk for OHSS.
authors.affiliation: a Maternal and Pediatric Department , USSD Centro PMA, Ospedale Papa Giovanni XXIII , Bergamo , Italy and.|b School of Obstetrics, University of Milano-Bicocca , Milano , Italy.
authors.forename: Francesco M
authors.initials: FM
authors.lastname: Fusi
authors.affiliation: a Maternal and Pediatric Department , USSD Centro PMA, Ospedale Papa Giovanni XXIII , Bergamo , Italy and.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Arnoldi
authors.affiliation: a Maternal and Pediatric Department , USSD Centro PMA, Ospedale Papa Giovanni XXIII , Bergamo , Italy and.
authors.forename: Chiara
authors.initials: C
authors.lastname: Bosisio
authors.affiliation: a Maternal and Pediatric Department , USSD Centro PMA, Ospedale Papa Giovanni XXIII , Bergamo , Italy and.
authors.forename: Grazia
authors.initials: G
authors.lastname: Lombardo
authors.affiliation: a Maternal and Pediatric Department , USSD Centro PMA, Ospedale Papa Giovanni XXIII , Bergamo , Italy and.
authors.forename: Marina
authors.initials: M
authors.lastname: Ferrario
authors.affiliation: a Maternal and Pediatric Department , USSD Centro PMA, Ospedale Papa Giovanni XXIII , Bergamo , Italy and.
authors.forename: Laura
authors.initials: L
authors.lastname: Zanga
authors.affiliation: a Maternal and Pediatric Department , USSD Centro PMA, Ospedale Papa Giovanni XXIII , Bergamo , Italy and.
authors.forename: Alessia
authors.initials: A
authors.lastname: Galimberti
authors.affiliation: a Maternal and Pediatric Department , USSD Centro PMA, Ospedale Papa Giovanni XXIII , Bergamo , Italy and.
authors.forename: Enrica
authors.initials: E
authors.lastname: Capitanio
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000150:complications / Q000188:drug therapy*; D008183:Luteal Phase; D008186:Luteolytic Agents / Q000627:therapeutic use*; D016471:Ovarian Hyperstimulation Syndrome / Q000453:epidemiology*; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D011374:Progesterone / Q000627:therapeutic use; D011372:Progestins / Q000627:therapeutic use; D012102:Reproductive Control Agents / Q000627:therapeutic use*; D012306:Risk; D017329:Triptorelin Pamoate / Q000627:therapeutic use
chemical_list: D006063:Chorionic Gonadotropin; D006727:Hormone Antagonists; D006728:Hormones; D008186:Luteolytic Agents; D011372:Progestins; D012102:Reproductive Control Agents; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D005640:Follicle Stimulating Hormone
keywords: GnRH agonist; in vitro fertilization; luteal phase support; ovarian hyperstimulation syndrome; trigger