GnRH agonist trigger with intensive luteal phase support vs. human chorionic gonadotropin trigger in high responders: an observational study reporting pregnancy outcomes and incidence of ovarian hyperstimulation syndrome.
A retrospective, cohort study of high-risk patients undergoing IVF treatment was performed to assess if there is a difference in clinical pregnancy rate, live birth rate and the incidence of ovarian hyperstimulation syndrome, when a GnRH agonist (GnRHa) trigger with intensive luteal support is compared to human chorionic gonadotropin (hCG) with standard luteal support. The control group consisted of 382 high-risk patients having a GnRH antagonist protocol with 194 receiving an hCG trigger. All patients had ≥18 follicles ≥11mm or serum oestradiol >18,000pmol/l on the day of trigger. Patients had a single or double embryo transfer at cleavage or blastocyst stage. Logistic regression was used to adjust for differences between the groups. An intention-to-treat analysis of all cycles was performed. No statistically significant differences were observed in terms of positive pregnancy test, clinical pregnancy rate and live birth rate. Only one patient (0.3%) was hospitalized with severe OHSS in the GnRHa group, compared to 26 patients (13%) in the hCG group. In conclusion, GnRHa trigger is associated with similar pregnancy rates with hCG trigger and a significant reduction in hospitalization for severe OHSS after an intention to treat analysis was performed.
a IVF Unit , Hammersmith Hospital , London , UK ;
Georgios
G
Christopoulos
a IVF Unit , Hammersmith Hospital , London , UK ;
Antonios
A
Vlismas
b Boston Place Clinic , London , UK.
Anna
A
Carby
a IVF Unit , Hammersmith Hospital , London , UK ;|b Boston Place Clinic , London , UK.
Stuart
S
Lavery
a IVF Unit , Hammersmith Hospital , London , UK ;|b Boston Place Clinic , London , UK.
Geoffrey
G
Trew
D000328:Adult; D006063:Chorionic Gonadotropin / Q000009:adverse effects*; D005260:Female; D005300:Fertility Agents, Female / Q000009:adverse effects* / Q000627:therapeutic use; D005307:Fertilization in Vitro / Q000009:adverse effects; D005640:Follicle Stimulating Hormone / Q000009:adverse effects* / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors / Q000627:therapeutic use; D006727:Hormone Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007247:Infertility, Female / Q000628:therapy*; D008183:Luteal Phase; D016471:Ovarian Hyperstimulation Syndrome / Q000453:epidemiology* / Q000209:etiology; D010062:Ovulation Induction / Q000009:adverse effects* / Q000379:methods; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012189:Retrospective Studies
D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone; D005640:Follicle Stimulating Hormone; C061018:ganirelix
GnRH agonist; IVF; buserelin; hCG; ovarian hyperstimulation syndrome