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2018•Chin J Reprod ContracepRequires access

Application of gonadotropin-releasing hormone agonist combined with low dose human chorionic gonadotropin trigger in the in vitro fertilization of high responder

Shuo Yang, Yilei He, Liang Liang, Rong Li, Xinna Chen, Xiumei Zhen, Lina Wang, Haiyan Wang, Caihong Ma, Ping Liu, Jie Qiao

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Abstract

Objective To investigate the effectiveness and safety of low dose human chorionic gonadotropin (hCG) dual trigger, by comparing thein vitrofertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes of high responders using low dose hCG dual trigger or standard hCG trigger. Methods This was a retrospective cohort study. The patients accepted IVF/ICSI treatment in Reproductive Medical Center of Peking University, between Jan. 1st 2014 and Dec. 31st 2015, with gonadotropin-releasing hormone antagonist (GnRH-A) flexible protocol. The research group was high responders using low dose hCG dual trigger (group A,n=431), paired by age and number of oocytes retrieved (1∶2), over the same period (group B,n=862). The general characteristics and treatment outcomes were compared between the two groups. Results There were no significant differences between the two groups refer to general characteristics, and gonadotropin (Gn) used dosage (P>0.05). The serum E2level on hCG trigger day in group A [(16 261±6 561pmol/L] was significantly higher than that in group B [(12 795±6 133)pmol/L, P=0.000]. The fertilization rate of ICSI and MIIoocyte rate were comparable between two groups (P>0.05). The rate of two pronucleus (2PN) oocytes was significantly higher in group A (56.0%) than that in group B (54.7%) (P=0.001). The clinical pregnancy rate, the implantation rate, the miscarriage rate and live birth rate were comparable between two groups (P>0.05). There were 5 patients in group A who suffered severe ovarian hyperstimulation syndrome (OHSS). Conclusion For high responders, besides of GnRH antagonist protocol, using low dose hCG dual trigger, will get satisfied clinical outcomes and do not increase the incidence of OHSS, and get satisfied clinical outcomes in fresh cycle. Key words: GnRH antagonist (GnRH-A); High responder; Controlled ovarian stimulation (COS); GnRH agonist (GnRHa) trigger; Dual trigger

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What this paper is about

Objective To investigate the effectiveness and safety of low dose human chorionic gonadotropin (hCG) dual trigger, by comparing thein vitrofertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes of high responders using low dose hCG dual trigger or standard hCG trigger. Methods This was a retrospective cohort study. The patients accepted IVF/ICSI treatment in Reproductive Medical Center of Peking University, between Jan. 1st 2014 and Dec. 31st 2015, with gonadotropin-releasing hormone antagonist (GnRH-A) flexible protocol. The research group was high responders using low dose hCG dual trigger (group A,n=431), paired by age and number of oocytes retrieved (1∶2), over the same period (group B,n=862). The general characteristics and treatment outcomes were compared between the two groups. Results There were no significant differences between the two groups refer to general characteristics, and gonadotropin (Gn) used dosage (P>0.05). The serum E2level on hCG trigger day in group A [(16 261±6 561pmol/L] was significantly higher than that in group B [(12 795±6 133)pmol/L, P=0.000]. The fertilization rate of ICSI and MIIoocyte rate were comparable between two groups (P>0.05). The rate of two pronucleus (2PN) oocytes was significantly higher in group A (56.0%) than that in group B (54.7%) (P=0.001). The clinical pregnancy rate, the implantation rate, the miscarriage rate and live birth rate were comparable between two groups (P>0.05). There were 5 patients in group A who suffered severe ovarian hyperstimulation syndrome (OHSS). Conclusion For high responders, besides of GnRH antagonist protocol, using low dose hCG dual trigger, will get satisfied clinical outcomes and do not increase the incidence of OHSS, and get satisfied clinical outcomes in fresh cycle. Key words: GnRH antagonist (GnRH-A); High responder; Controlled ovarian stimulation (COS); GnRH agonist (GnRHa) trigger; Dual trigger

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Available abstract

Objective To investigate the effectiveness and safety of low dose human chorionic gonadotropin (hCG) dual trigger, by comparing thein vitrofertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes of high responders using low dose hCG dual trigger or standard hCG trigger. Methods This was a retrospective cohort study. The patients accepted IVF/ICSI treatment in Reproductive Medical Center of Peking University, between Jan. 1st 2014 and Dec. 31st 2015, with gonadotropin-releasing hormone antagonist (GnRH-A) flexible protocol. The research group was high responders using low dose hCG dual trigger (group A,n=431), paired by age and number of oocytes retrieved (1∶2), over the same period (group B,n=862). The general characteristics and treatment outcomes were compared between the two groups. Results There were no significant differences between the two groups refer to general characteristics, and gonadotropin (Gn) used dosage (P>0.05). The serum E2level on hCG trigger day in group A [(16 261±6 561pmol/L] was significantly higher than that in group B [(12 795±6 133)pmol/L, P=0.000]. The fertilization rate of ICSI and MIIoocyte rate were comparable between two groups (P>0.05). The rate of two pronucleus (2PN) oocytes was significantly higher in group A (56.0%) than that in group B (54.7%) (P=0.001). The clinical pregnancy rate, the implantation rate, the miscarriage rate and live birth rate were comparable between two groups (P>0.05). There were 5 patients in group A who suffered severe ovarian hyperstimulation syndrome (OHSS). Conclusion For high responders, besides of GnRH antagonist protocol, using low dose hCG dual trigger, will get satisfied clinical outcomes and do not increase the incidence of OHSS, and get satisfied clinical outcomes in fresh cycle. Key words: GnRH antagonist (GnRH-A); High responder; Controlled ovarian stimulation (COS); GnRH agonist (GnRHa) trigger; Dual trigger

Key concepts: Intracytoplasmic sperm injection, Human chorionic gonadotropin, Medicine, In vitro fertilisation, Ovarian hyperstimulation syndrome, Andrology, Gynecology, Miscarriage

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Application of gonadotropin-releasing hormone agonist combined with low dose human chorionic gonadotropin trigger in the in vitro fertilization of high responder — Research Paper | ScholarLens