Intranasal gonadotropin-releasing hormone agonist (GnRHa) for luteal-phase support following GnRHa triggering, a novel approach to avoid ovarian hyperstimulation syndrome in high responders.
To study whether intranasal GnRH agonist (GnRHa) can be effectively used for luteal support in high-responder patients undergoing fresh-embryo transfer after ovulation induction with the use of GnRHa.



Retrospective cohort study.



Private fertility clinic.



Forty-six high-responder patients were administered a GnRHa ovulation trigger to avoid ovarian hyperstimulation syndrome (OHSS), followed by 2 weeks of daily intranasal GnRHa (nafarelin) for luteal-phase support. No additional progesterone supplementation was administrated.



Intranasal GnRHa for luteal-phase support.



The primary outcome was ongoing clinical pregnancy rate.



High median progesterone levels were measured at midluteal phase and on the day of the first positive pregnancy test (190 nmol/L on both measures). We obtained 24 (52.1%) ongoing clinical pregnancies. None of the patients developed OHSS.



Intranasal GnRHa is effective in achieving luteal-phase support in high-responder patients triggered with GnRHa and avoiding OHSS.
Fertility Center From A to Z, Ramat Aviv, Israel; IVF Unit, Assuta Medical Center, Rishon Lezion, Israel. Electronic address: barhava@gmail.com.
Itai
I
Bar-Hava
Department of Obstetrics & Gynecology, Edith Wolfson Medical Center, Holon, Israel.
Yossi
Y
Mizrachi
Fertility Center From A to Z, Ramat Aviv, Israel.
Daphne
D
Karfunkel-Doron
Fertility Center From A to Z, Ramat Aviv, Israel.
Yeela
Y
Omer
Fertility Center From A to Z, Ramat Aviv, Israel.
Liron
L
Sheena
Fertility Center From A to Z, Ramat Aviv, Israel.
Nurit
N
Carmon
Fertility Center From A to Z, Ramat Aviv, Israel; IVF Unit, Assuta Medical Center, Rishon Lezion, Israel.
Gila
G
Ben-David
D000281:Administration, Intranasal; D000328:Adult; D004334:Drug Administration Schedule; D004624:Embryo Transfer; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D005307:Fertilization in Vitro; D043373:Follicle Stimulating Hormone, Human / Q000008:administration & dosage; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000819:agonists* / Q000031:analogs & derivatives / Q000037:antagonists & inhibitors; D006727:Hormone Antagonists / Q000008:administration & dosage; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008596:Menotropins / Q000008:administration & dosage; D017274:Nafarelin / Q000008:administration & dosage* / Q000009:adverse effects; D054315:Oocyte Retrieval; D016471:Ovarian Hyperstimulation Syndrome / Q000139:chemically induced / Q000503:physiopathology / Q000517:prevention & control*; D010060:Ovulation / Q000187:drug effects*; D010062:Ovulation Induction / Q000009:adverse effects / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011994:Recombinant Proteins / Q000008:administration & dosage; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D005300:Fertility Agents, Female; D043373:Follicle Stimulating Hormone, Human; D006727:Hormone Antagonists; D011994:Recombinant Proteins; C571801:follitropin alfa; D017274:Nafarelin; D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins; C061018:ganirelix
GnRH agonist; IVF; OHSS; luteal support