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Gnrh agonist trigger

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https://www.readbyqxmd.com/read/29850443/empty-follicle-syndrome-following-gnrha-trigger-in-pcos-patients-undergoing-ivf-cycles
#1
Krishna Deepika, Davuluri Sindhuma, Bijlani Kiran, Nair Ravishankar, Praneesh Gautham, Rao Kamini
Background: The objective of this study was to analyze the incidence and the underlying mechanisms of empty follicle syndrome (EFS) occurring in gonadotropin releasing hormone agonist (GnRHa) triggered in in vitro fertilization (IVF) cycles with GnRH antagonist protocol in women with polycystic ovary syndrome (PCOS) of Indian origin. The study also intended to evaluate the cycle outcome following a rescue trigger. Methods: Retrospective cohort analysis of data was extracted from the hospital database of 271 PCOS patients who underwent IVF in antagonist protocol triggered with GnRHa from August 2014 to December 2016...
January 2018: Journal of Reproduction & Infertility
https://www.readbyqxmd.com/read/29843716/the-vegf-and-pedf-levels-in-the-follicular-fluid-of-patients-co-treated-with-letrozole-and-gonadotropins-during-the-stimulation-cycle
#2
Jigal Haas, Rawad Bassil, Noa Gonen, Jim Meriano, Andrea Jurisicova, Robert F Casper
BACKGROUND: Previous studies have shown that androgens, in addition to serving as precursors for ovarian estrogen synthesis, also have a fundamental role in primate ovarian follicular development by augmentation of FSH receptor expression on granulosa cells. Recent studies have shown that aromatase inhibitor, letrozole, improves ovarian response to FSH in normal and poor responder patients, possibly by increasing intraovarian androgen levels. Studies in mice also showed an effect of letrozole to increase pigment epithelium-derived factor (PEDF) and to lower vascular epithelial growth factor (VEGF), which might be expected to reduce the risk of ovarian hyperstimulation syndrome (OHSS) with stimulation...
May 29, 2018: Reproductive Biology and Endocrinology: RB&E
https://www.readbyqxmd.com/read/29807533/progestin-primed-milder-stimulation-with-clomiphene-citrate-yields-fewer-oocytes-and-suboptimal-pregnancy-outcomes-compared-with-the-standard-progestin-primed-ovarian-stimulation-in-infertile-women-with-polycystic-ovarian-syndrome
#3
Hongjuan Ye, Hui Tian, Wen He, Qifeng Lyu, Yanping Kuang, Qiuju Chen, Lihua Sun
BACKGROUND: Oral progestin has recently been used to prevent premature LH surges in ovarian stimulation, and this progestin-primed ovarian stimulation (PPOS) is effective and safe in patients with different ovarian reserves. The current data are lacking regarding how to individualize the gonadotropin dose and regimen for women with polycystic ovarian syndrome (PCOS). A retrospective cohort trial was performed to evaluate the efficacy of progestin-primed milder stimulation with clomiphene citrate (CC) compared to the standard progestin-primed ovarian stimulation (PPOS) protocol for infertile women with PCOS...
May 28, 2018: Reproductive Biology and Endocrinology: RB&E
https://www.readbyqxmd.com/read/29778367/role-of-gonadotropin-releasing-hormone-agonists-human-chorionic-gonadotropin-hcg-progesterone-and-estrogen-in-luteal-phase-support-after-hcg-triggering-and-when-in-pregnancy-hormonal-support-can-be-stopped
#4
REVIEW
Dominique de Ziegler, Paul Pirtea, Claus Yding Andersen, Jean Marc Ayoubi
Luteal phase support is mandatory in ovarian stimulation cycles in assisted reproductive technology owing to a deficit in LH pulsatility after the effects of exogenous hCG-used for triggering ovulation-vanish. This is classically accomplished by means of exogenous P administration, but emerging new options include microdoses of hCG and exogenous GnRH agonist. Although luteal phase support is commonly continued for up to 10 weeks into pregnancy, there is accumulating evidence that it can be stopped after the first ultrasound or even after a positive pregnancy test...
May 2018: Fertility and Sterility
https://www.readbyqxmd.com/read/29754425/effects-of-oestradiol-for-luteal-phase-support-in-fresh-embryo-transfer-cycles-a-retrospective-cohort-study
#5
Wei Zhao, Yifeng Liu, Peng Xu, Yiqing Wu, Kai Chen, Xiaoyan Guo, Fan Zhang, Yun Huang, Linlin Zhu, Runjv Zhang, Dan Zhang
OBJECTIVE: Any benefit of oestradiol supplementation with progesterone for luteal support after fresh embryo transfer in in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) cycles remains controversial. In this study, we further addressed this question in cycles using gonadotropin-releasing hormone (GnRH) agonist for ovarian stimulation. DESIGN: A retrospective cohort study in a tertiary teaching and research hospital. PATIENT(S): A total of 1602 patients were given oestradiol valerate (E) in addition to progesterone (P) as luteal support...
May 12, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29743877/follicle-size-on-day-of-trigger-most-likely-to-yield-a-mature-oocyte
#6
Ali Abbara, Lan N Vuong, Vu N A Ho, Sophie A Clarke, Lisa Jeffers, Alexander N Comninos, Rehan Salim, Tuong M Ho, Tom W Kelsey, Geoffrey H Trew, Peter Humaidan, Waljit S Dhillo
Objective: To identify follicle sizes on the day of trigger most likely to yield a mature oocyte following hCG, GnRH agonist (GnRHa), or kisspeptin during IVF treatment. Design: Retrospective analysis to determine the size of follicles on day of trigger contributing most to the number of mature oocytes retrieved using generalized linear regression and random forest models applied to data from IVF cycles (2014-2017) in which either hCG, GnRHa, or kisspeptin trigger was used...
2018: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29738181/-repeated-superovulation-induction-after-failure-in-previous-ivf-et-cycles-with-the-ultra-long-protocol-analysis-of-outcomes-of-clinical-pregnancy
#7
Bin Wang, Na Kong, Jing-Yu Liu, Ning-Yuan Zhang, Ying-Chun Zhu, Jian-Jun Zhou
Objective: To analyze the clinical outcomes of repeated superovulation induction in patients with adenomyosis or moderate to severe pelvic endometriosis after failure in previous IVF-ET cycles with the ultra-long protocol. METHODS: We retrospectively analyzed the clinical data about 37 patients with adenomyosis or moderate to severe pelvic endometriosis in our center from 2009 to 2013, who underwent repeated IVF-ET after failure in the previous cycles with the ultra-long protocol, namely by injection of 2-6 ampoules of 3...
December 2017: Zhonghua Nan Ke Xue, National Journal of Andrology
https://www.readbyqxmd.com/read/29696192/the-dual-trigger-study-rationale-and-study-design-of-a-prospective-double-blind-randomized-clinical-trial-comparing-pregnancy-rates-after-co-administration-of-low-dose-hcg-at-the-time-of-gnrh-agonist-trigger-or-35-h-later-for-the-prevention-of-ohss
#8
Daniel Griffin, Claudio Benadiva, Tara Budinetz, Carolina Sueldo, Andrea DiLuigi, John Nulsen, Lawrence Engmann
Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of controlled ovarian stimulation. The use of gonadotropin releasing hormone (GnRH) agonist for the trigger of oocyte maturation is effective in the prevention of OHSS although it may result in a lower pregnancy rate. The use of adjuvant low dose human chorionic gonadotropin (hCG) at the time of trigger or at the time of oocyte retrieval may improve pregnancy rates. The goal of this dual trigger study is to evaluate the safety and efficacy of the use of low dose hCG administered at the time of GnRH agonist trigger or 35 h later as well as the potential impact on pregnancy rates...
December 2017: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/29692679/clinical-outcomes-of-assisted-reproductive-technology-treatment-by-using-a-self-injection-of-recombinant-human-chorionic-gonadotropin-as-the-final-maturation-trigger
#9
Koji Nakagawa, Midori Oba, Kaori Ehara, Nozomi Ishigaki, Nao Ino, Akiko Itakura, Ryo Tsutsumi, Katsuki Nakao, Yuko Ojiro, Rikikazu Sugiyama
Purpose: To evaluate the efficacy and safety of self-injections of the prefilled recombinant human chorionic gonadotropin (r-hCG) in a syringe in assisted reproductive technology (ART) treatment for the maturation trigger (MT), as compared to self-injections of conventional hCG and intranasal administration of gonadotropin-releasing hormone agonist (GnRH-a). Methods: Between January and April, 2017, 396 patients who underwent oocyte retrieval were recruited. Of these, 396 patients were classified into three groups, according to the types of MT: (1) the urinary human chorionic gonadotropin (u-hCG) group that consisted of patients who had a self-injection of u-hCG (n = 127); (2) the GnRH-a group that received nasal administration of GnRH-a (n = 159); and (3) the r-hCG group that had a self-injection of r-hCG (n = 110)...
April 2018: Reproductive Medicine and Biology
https://www.readbyqxmd.com/read/29680315/luteal-phase-support-after-gonadotropin-releasing-hormone-agonist-triggering-does-it-still-matter
#10
REVIEW
Claudio Benadiva, Lawrence Engmann
Despite the increasing utilization of freeze-only IVF protocols, there is still a need for adequate management of the luteal phase after GnRH agonist trigger for patients who desire a fresh embryo transfer. Two approaches, intensive luteal support with E2 and P, and the use of adjuvant low-dose hCG either at the time of GnRH agonist trigger (dual trigger) or at the time of oocyte retrieval, have been shown to be effective in maintaining adequate pregnancy outcomes. The addition of low-dose hCG should be used with caution, because it may increase the risk of ovarian hyperstimulation syndrome...
May 2018: Fertility and Sterility
https://www.readbyqxmd.com/read/29675483/fresh-versus-frozen-embryo-transfer-after-gonadotropin-releasing-hormone-agonist-trigger-in-gonadotropin-releasing-hormone-antagonist-cycles-among-high-responder-women-a-randomized-multi-center-study
#11
Abbas Aflatoonian, Mahnaz Mansoori-Torshizi, Maryam Farid Mojtahedi, Behrouz Aflatoonian, Mohammaad Ali Khalili, Mohammad Hossein Amir-Arjmand, Mehrdad Soleimani, Nastaran Aflatoonian, Homa Oskouian, Nasim Tabibnejad, Peter Humaidan
Background: The use of embryo cryopreservation excludes the possible detrimental effects of ovarian stimulation on the endometrium, and higher reproductive outcomes following this policy have been reported. Moreover, gonadotropin-releasing hormone agonist trigger in gonadotropin-releasing hormone (GnRH) antagonist cycles as a substitute for standard human chorionic gonadotropin trigger, minimizes the risk of ovarian hyperstimulation syndrome (OHSS) in fresh as well as frozen embryo transfer cycles (FET)...
January 2018: International Journal of Reproductive Biomedicine (Yazd, Iran)
https://www.readbyqxmd.com/read/29600322/dual-triggering-with-gnrh-agonist-plus-hcg-versus-triggering-with-hcg-alone-for-ivf-icsi-outcome-in-gnrh-antagonist-cycles-a-systematic-review-and-meta-analysis
#12
REVIEW
Chi-Huang Chen, Chii-Ruey Tzeng, Peng-Hui Wang, Wei-Min Liu, Heng-Yu Chang, Huang-Hui Chen, Ching-Hui Chen
PURPOSE: To summarize available evidence from randomized-controlled trials which have evaluated triggering of final oocyte maturation with concomitant GnRH agonists and hCG in patients undergoing IVF, and to analyze whether dual triggering is as efficacious as hCG triggering in terms of oocyte and pregnancy outcomes. METHODS: A comprehensive literature search was performed to identify randomized-controlled trials comparing IVF outcomes between women receiving combined administration of hCG with GnRH agonists and those receiving hCG alone for triggering of final oocyte maturation...
March 29, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29562260/towards-an-optimal-luteal-support-modality-in-agonist-triggered-cycles-a-randomized-clinical-trial
#13
E A Elgindy, H Sibai, M I Mostafa, A Gibreel, E Darwish, H Maghraby
STUDY QUESTION: In ICSI patients with high risk of ovarian hyperstimulation syndrome (OHSS), are antagonist cycles triggered by gonadotropin releasing hormone (GNRH) agonist with a specialized luteal support regimen associated with comparable ongoing pregnancy rate (OPR) and less OHSS than those triggered by hCG? SUMMARY ANSWER: In antagonist ICSI cycles, GnRH agonist triggering with a specialized luteal support regimen is associated with comparable OPR to those triggered by hCG but may be less likely to be associated with OHSS...
June 1, 2018: Human Reproduction
https://www.readbyqxmd.com/read/29516855/dual-trigger-with-gonadotropin-releasing-hormone-and-human-chorionic-gonadotropin-for-poor-responders
#14
Ahmet Eser, Belgin Devranoğlu, Evrim Bostancı Ergen, Çiğdem Yayla Abide
OBJECTIVE: To compare metaphase II (MII) rate, fertilization rate, and embryo quality with dual trigger gonadotropin-releasing hormone agonist (GnRH) and normal dose human chorionic gonadotropin (hCG) versus a normal dose hCG trigger in antagonist intracytoplasmic sperm injection (ICSI) cycles of poor ovarian responders. MATERIAL AND METHODS: Patients defined as poor ovarian responders according to the Bologna criteria who underwent ICSI with GnRH antagonist protocol and triggered with dual trigger or hCG alone for oocyte maturation...
March 8, 2018: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/29497400/luteal-coasting-and-individualization-of-human-chorionic-gonadotropin-dose-after-gonadotropin-releasing-hormone-agonist-triggering-for-final-oocyte-maturation-a-retrospective-proof-of-concept-study
#15
Barbara Lawrenz, Suzan Samir, Nicolas Garrido, Laura Melado, Nils Engelmann, Human M Fatemi
Ovarian stimulation in a gonadotropin-releasing hormone (GnRH) antagonist protocol with the use of GnRH agonist for final oocyte maturation is the state-of-the-art treatment in patients with an expected or known high response to avoid or at least reduce significantly the risk for development of ovarian hyperstimulation syndrome (OHSS). Due to a shortened LH surge after administration of GnRH agonist in most patients, the luteal phase will be characterized by luteolysis and luteal phase insufficiency. Maintaining a sufficient luteal phase is crucial for achievement of a pregnancy; however, the optimal approach is still under debate...
2018: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29453138/increased-coagulation-index-as-measured-by-thromboelastography-during-ovarian-stimulation-for-in-vitro-fertilization-influence-of-the-final-oocyte-maturation-triggering-agent
#16
Ronit Beck-Fruchter, Israel Gavish, Shira Baram, Yoel Geslevich, Amir Weiss
OBJECTIVE: Thromboelastography (TEG) is a viscoelastic test of hemostasis which allows measurement of the processes of clot initiation, propagation, stabilization, and dissolution in real time. In this study we aimed to evaluate the alterations in coagulation as measured by TEG during In Vitro Fertilization (IVF) stimulation cycles and to investigate whether final oocyte maturation with recombinant hCG (rhCG) versus GnRH agonist results in a different coagulation state. STUDY DESIGN: This is a prospective observational study which included fifty-three normogonadotrophic women...
April 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29446481/clinical-parameters-of-ovarian-hyperstimulation-syndrome-following-different-hormonal-triggers-of-oocyte-maturation-in-ivf-treatment
#17
A Abbara, R Islam, S A Clarke, L Jeffers, G Christopoulos, A N Comninos, R Salim, S A Lavery, T N L Vuong, P Humaidan, T W Kelsey, G H Trew, W S Dhillo
OBJECTIVE: Ovarian hyperstimulation syndrome (OHSS) is a serious iatrogenic condition, predominantly related to the hormone used to induce oocyte maturation during IVF treatment. Kisspeptin is a hypothalamic neuropeptide that has recently been demonstrated to safely trigger final oocyte maturation during IVF treatment even in women at high risk of OHSS. However, to date, the safety of kisspeptin has not been compared to current hormonal triggers of oocyte maturation. DESIGN: We conducted a retrospective single-centre cohort study investigating symptoms and clinical parameters of early OHSS in women at high risk of OHSS (antral follicle count or total number of follicles on day of trigger ≥23) triggered with human chorionic gonadotrophin (hCG) (n = 40), GnRH agonist (GnRHa; n = 99) or kisspeptin (n = 122) at Hammersmith Hospital IVF unit, London, UK (2013-2016)...
February 15, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29435182/dual-trigger-of-triptorelin-and-hcg-optimizes-clinical-outcome-for-high-ovarian-responder-in-gnrh-antagonist-protocols
#18
Saijiao Li, Danni Zhou, Tailang Yin, Wangming Xu, Qingzhen Xie, Dan Cheng, Jing Yang
In this paper, a retrospective cohort study was conducted to the high ovarian responders in GnRH-antagonist protocols of IVF/ICSI cycles. The purpose of the study is to investigate whether dual triggering of final oocyte maturation with a combination of gonadotropin-releasing hormone (GnRH) agonist and human chorionic gonadotropin (HCG) can improve the clinical outcome compared with traditional dose (10000IU) HCG trigger and low-dose (8000IU) HCG trigger for high ovarian responders in GnRH-antagonist in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI) cycles...
January 12, 2018: Oncotarget
https://www.readbyqxmd.com/read/29430154/repeat-dose-of-gonadotropin-releasing-hormone-agonist-trigger-in-polycystic-ovarian-syndrome-undergoing-in-vitro-fertilization-cycles-provides-a-better-cycle-outcome-a-proof-of-concept-study
#19
Krishna Deepika, Pookilath Baiju, Praneesh Gautham, Rathore Suvarna, Vohra Arveen, Rao Kamini
Objective: Is a single dose of gonadotropin-releasing hormone agonist (GnRHa) trigger to induce final oocyte maturation in polycystic ovarian syndrome (PCOS) undergoing in vitro fertilization (IVF) cycles with GnRH antagonist protocol sufficient to provide optimal oocyte maturity? Design: This is a prospective, randomized, double-blind, proof-of-concept study. Setting: This study was carried out at a tertiary care center. Material and Methods: A total of 125 patients diagnosed with PCOS defined as per the ESHRE/ASRM Rotterdam criteria (2003) undergoing IVF in antagonist protocol were randomized into two groups...
October 2017: Journal of Human Reproductive Sciences
https://www.readbyqxmd.com/read/29430153/the-impact-of-progesterone-level-on-day-of-hcg-injection-in-ivf-cycles-on-clinical-pregnancy-rate
#20
Jawa Ashmita, Swarankar Vikas, Garg Swati
Background: Premature progesterone rise (PPR) has long been implicated as contributing to implantation failure. Despite the use of gonadotropin-releasing hormone (GnRH) analogues, subtle increases in serum progesterone ( P 4 ) levels beyond a threshold progesterone concentration were observed on the day of trigger in controlled ovarian hyperstimulation cycles. Aims: The purpose of the study was to evaluate the incidence of PPR on the day of trigger in conventional IVF/ICSI cycles and its impact on clinical pregnancy rate...
October 2017: Journal of Human Reproductive Sciences
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