title: The benefit of individualized low-dose hCG support for high responders in GnRHa-triggered IVF/ICSI cycles.
abstract: BACKGROUND
  To assess the pregnancy outcome and ovarian hyperstimulation syndrome (OHSS) incidence in high responders receiving gonadotropin-releasing hormone agonist (GnRHa) trigger plus individualized support of low-dose human chorionic gonadotropin (hCG). Such support includes 500-1000 IU hCG given at trigger and, if serum estradiol (E2) dropped to below 800 pg/mL before the 6(th) day after oocyte retrieval, an additional rescue dose of 300 IU hCG.
  
  
  METHODS
  This was a retrospective study of potential high responders aged from 28 years to 40 years at a tertiary fertility center in Taiwan. By means of chart review, we assessed the pregnancy outcome and OHSS incidence in high responders receiving GnRHa trigger plus individualized low-dose hCG support. The main outcomes were measured by ongoing pregnancy rate and OHSS incidence (SPSS), in which statistical significance was determined by Chi-square test.
  
  
  RESULTS
  Moderate to severe OHSS did not develop in any patient receiving GnRHa trigger plus individualized low-dose hCG support. In fact, a satisfactory ongoing pregnancy rate (46.9%) was noted in patients receiving GnRHa trigger plus individualized low-dose hCG support.
  
  
  CONCLUSIONS
  Our study suggested that GnRHa trigger combined with individualized low-dose hCG support appears to be a safe approach with a satisfactory pregnancy outcome.
authors.affiliation: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Division of Obstetrics and Gynecology, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Chen-Yu
authors.initials: CY
authors.lastname: Huang
authors.affiliation: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Miawh-Lirng
authors.initials: ML
authors.lastname: Shieh
authors.affiliation: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Division of Obstetrics and Gynecology, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC. Electronic address: lihy@vghtpe.gov.tw.
authors.forename: Hsin-Yang
authors.initials: HY
authors.lastname: Li
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage*; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000494:pharmacology; D006801:Humans; D016471:Ovarian Hyperstimulation Syndrome / Q000453:epidemiology; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000097:blood; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*
chemical_list: D006063:Chorionic Gonadotropin; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D004958:Estradiol
keywords: agonist trigger; high responders; human chorionic gonadotropin (hCG); in vitro fertilization (IVF); ovarian hyperstimulation syndrome (OHSS)