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Gnrh agonist trigger

Ashraf Alyasin, Shayesteh Mehdinejadiani, Marzieh Ghasemi
Routinely, a bolus of 5.000-10.000 IU human chorionic gonadotropin (hCG) is used for the final follicular maturation and ovulation as a standard method. HCG has the same effect of luteinizing hormone (LH) with long half-life. It has the long lutheotrophic effect which increases the risk of ovarian hyper stimulation syndrome (OHSS). Recently, gonadotropin-releasing hormone agonist (GnRH-a) trigger has been used for the induction of final follicular maturation and ovulation with the aim of reducing the OHSS risk...
September 2016: International Journal of Reproductive Biomedicine (Yazd, Iran)
W Decleer, K Verschueren, S Vandeginste, K Osmanagaoglu, P Devroey
OBJECTIVE: To demonstrate the feasibility of scheduling an IVF cycle, without disadvantages, in the new patient friendly stimulation protocol using the long acting Corifollitropin Alfa, in combination with GnRH-antagonist protection and GnRH-agonist triggering. STUDY DESIGN: Two groups of ten patients were admitted in the study. Both received the same stimulation protocol with Corifollitropin Alfa in combination with GnRH-antagonist protection. After ultrasound evaluation on day 7 individually dosed Menopur was added...
December 28, 2015: Facts, Views & Vision in ObGyn
Imre Farkas, Csaba Vastagh, Erzsébet Farkas, Flóra Bálint, Katalin Skrapits, Erik Hrabovszky, Csaba Fekete, Zsolt Liposits
Glucagon-like peptide-1 (GLP-1), a metabolic signal molecule, regulates reproduction, although, the involved molecular mechanisms have not been elucidated, yet. Therefore, responsiveness of gonadotropin-releasing hormone (GnRH) neurons to the GLP-1 analog Exendin-4 and elucidation of molecular pathways acting downstream to the GLP-1 receptor (GLP-1R) have been challenged. Loose patch-clamp recordings revealed that Exendin-4 (100 nM-5 μM) elevated firing rate in hypothalamic GnRH-GFP neurons of male mice via activation of GLP-1R...
2016: Frontiers in Cellular Neuroscience
Georgios Christopoulos, Antonios Vlismas, Anna Carby, Stuart Lavery, Geoffrey Trew
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...
September 2016: Human Fertility: Journal of the British Fertility Society
Samuel Santos-Ribeiro, Nikolaos P Polyzos, Vuong Thi Ngoc Lan, Johannie Siffain, Shari Mackens, Lisbet Van Landuyt, Herman Tournaye, Christophe Blockeel
STUDY QUESTION: Does the timing of the first frozen embryo transfer (FET) after gonadotropin-releasing hormone (GnRH) agonist triggering with the elective cryopreservation of all embryos affect pregnancy outcome? SUMMARY ANSWER: FETs performed immediately after a freeze-all cycle did not vary significantly from delayed FETs in terms of pregnancy rates. WHAT IS KNOWN ALREADY: As interest in, and use of, the freeze-all strategy expands in the field of reproductive medicine, the optimal timing to perform the subsequent FET has become increasingly important...
September 8, 2016: Human Reproduction
Akiko Takahashi, Shinji Kanda, Tomohiro Abe, Yoshitaka Oka
Reproduction is essential for life, but its regulatory mechanism is diverse. The analysis of this diversity should lead us to understand the evolutionary process of the regulation of reproduction. In mammals, the hypothalamic-pituitary-gonadal axis plays an essential role in such regulation, and each component, hypothalamic GnRH, and pituitary gonadotropins, LH, and FSH, is indispensable. However, the common principle of the hypothalamic-pituitary-gonadal axis regulation among vertebrates remains unclear. Here, we used a teleost medaka, which is phylogenetically distant from mammals, and analyzed phenotypes of gene knockouts (KOs) for GnRH, LH, and FSH...
October 2016: Endocrinology
Xuefeng Lu, Qingqing Hong, LiHua Sun, Qiuju Chen, Yonglun Fu, AiAi, Qifeng Lyu, Yanping Kuang
OBJECTIVE: To identify the risk factors for suboptimal response to GnRH agonist (GnRH-a) trigger and evaluate the effect of hCG on the outcome of patients with suboptimal response to GnRH-a. DESIGN: A retrospective data analysis. SETTING: A tertiary-care academic medical center. PATIENT(S): A total of 8,092 women undergoing 8,970 IVF/intracytoplasmic sperm injection (ICSI) treatment cycles. INTERVENTION(S): All women underwent hMG + medroxyprogesterone acetate (MPA)/P treatment cycles during IVF/ICSI, which were triggered using a GnRH-a alone or in combination with hCG (1,000, 2,000, or 5,000 IU)...
August 1, 2016: Fertility and Sterility
M Le Chatton, C Wittemer, T Schweitzer, F Lestrade, J-P Ragage
OBJECTIVES: The undeniable asset of the antagonist protocols in in vitro fertilization is the decrease of the risks of ovarian hyperstimulation syndrome, by the use of a release by GnRH agonist. Nevertheless, questioning persist concerning the rates of clinical pregnancies, the oocyte quantity and the empty follicle syndrome. We thus studied these parameters in our center. METHODS: A retrospective study was realized from January 1st, 2013 till July 31st, 2015...
July 2016: Gynécologie, Obstétrique & Fertilité
John Zhang
Minimal stimulation in vitro fertilization (mini-IVF) consists of a gentle controlled ovarian stimulation that aims to produce a maximum of five to six oocytes. There is a misbelief that mini-IVF severely compromises pregnancy and live birth rates. An appraisal of the literature pertaining to studies on mini-IVF protocols was performed. The advantages of minimal stimulation protocols are reported here with a focus on the use of clomiphene citrate (CC), gonadotropin releasing hormone (GnRH) ago- nist trigger for oocyte maturation, and freeze-all embryo strategy...
July 2016: International Journal of Fertility & Sterility
Xiuxian Zhu, Hongjuan Ye, Yonglun Fu
Poor oocyte quality is a main concern for decreased reproductive outcomes in women with polycystic ovarian syndrome (PCOS) during controlled ovarian hyperstimulation (COH). A primary way to improve oocyte quality is to optimize the COH protocol. It was demonstrated that the viable embryo rate per oocyte retrieved in the Utrogestan and hMG protocol, a novel regimen based on frozen-thawed embryo transfer (FET), is statistically higher than that in the short protocol. Thus, a retrospective study was conducted to evaluate the endocrine characteristics and clinical outcomes in PCOS patients subjected to the Utrogestan and hMG protocol compared with those subjected to the short protocol...
July 2016: Medicine (Baltimore)
Kathleen E O'Neill, Suneeta Senapati, Ivy Maina, Clarisa Gracia, Anuja Dokras
PURPOSE: The purpose of this study was to compare rates of ovarian hyperstimulation syndrome (OHSS) after using gonadotropin-releasing hormone agonists (GnRHa) alone and GnRHa in combination with low-dose human chorionic gonadotropin (hCG, dual trigger) for final oocyte maturation in women undergoing controlled ovarian hyperstimulation (COH). METHODS: A retrospective cohort study was conducted at an academic center. Study population included 108 women who received GnRHa trigger and 66 women who received dual trigger (GnRHa + low-dose [1000 IU] hCG trigger)...
September 2016: Journal of Assisted Reproduction and Genetics
P Humaidan, S M Nelson, P Devroey, C C Coddington, L B Schwartz, K Gordon, J L Frattarelli, B C Tarlatzis, H M Fatemi, P Lutjen, B J Stegmann
STUDY QUESTION: What is an objective approach that employs measurable and reproducible physiologic changes as the basis for the classification of ovarian hyperstimulation syndrome (OHSS) in order to facilitate more accurate reporting of incidence rates within and across clinical trials? SUMMARY ANSWER: The OHSS flow diagram is an objective approach that will facilitate consistent capture, classification and reporting of OHSS within and across clinical trials. WHAT IS KNOWN ALREADY: OHSS is a potentially life-threatening iatrogenic complication of the early luteal phase and/or early pregnancy after ovulation induction (OI) or ovarian stimulation (OS)...
September 2016: Human Reproduction
Jigal Haas, Libby Ophir, Eran Barzilay, Ronit Machtinger, Yuval Yung, Raoul Orvieto, Ariel Hourvitz
OBJECTIVE: To investigate the messenger RNA (mRNA) expression of reproduction-related genes in granulosa cells (GCs) of patients triggered with hCG compared with patients triggered with GnRH agonist and hCG (double trigger) for final oocyte maturation. DESIGN: Granulosa cells were obtained at the time of oocyte retrieval, and gene expression was analyzed using quantitative real-time polymerase chain reaction. SETTING: Referral center. PATIENT(S): Fifteen women undergoing controlled ovarian hyperstimulation for IVF who received hCG for final follicular maturation and in a subsequent IVF cycle received double trigger...
September 1, 2016: Fertility and Sterility
Frank E Chang, Stephanie A Beall, Jeris M Cox, Kevin S Richter, Alan H DeCherney, Michael J Levy
OBJECTIVE: To compare outcomes of in vitro fertilization (IVF) cycles with adequate versus inadequate response to the gonadotropin-releasing hormone (GnRH) agonist trigger rescued with the use of human chorionic gonadotropin (hCG) retrigger, and to identify risk factors associated with an inadequate trigger. DESIGN: Retrospective cohort study. SETTING: Private practice. PATIENT(S): Women at high risk for ovarian hyperstimulation syndrome who underwent an autologous IVF cycle and used GnRH agonist to trigger oocyte maturation before oocyte retrieval...
October 2016: Fertility and Sterility
Miro Kasum, Kristijan Kurdija, Slavko Orešković, Ermin Čehić, Dinka Pavičić-Baldani, Lana Škrgatić
The aim of the review is to analyse the combination of a gonadotrophin releasing hormone (GnRH) agonist with a human chorionic gonadotrophin (hCG) trigger, for final oocyte maturation in in vitro fertilisation (IVF) cycles. The concept being a ''dual trigger'' combines a single dose of the GnRH agonist with a reduced or standard dosage of hCG at the time of triggering. The use of a GnRH agonist with a reduced dose of hCG in high responders demonstrated luteal phase support with improved pregnancy rates, similar to those after conventional hCG and a low risk of ovarian hyperstimulation syndrome (OHSS)...
June 8, 2016: Gynecological Endocrinology
Michele Kwik, Elizabeth Maxwell
PURPOSE OF REVIEW: Severe ovarian hyperstimulation syndrome (OHSS) is an iatrogenic condition that affects 1% of women that undergo treatment with assisted reproductive technology. The review aims to summarize recent evidence on pathophysiology, treatment, and prevention of OHSS. RECENT FINDINGS: The pathophysiology is still not completely understood; however, vascular endothelial growth factor is likely to be an important mediator. Human chorionic gonadotropin was previously thought to be necessary for OHSS to occur; however, recent case reports have proven otherwise...
August 2016: Current Opinion in Obstetrics & Gynecology
Caitlin Dunne, Carole Lawrence, Arianne Albert, Jon C Havelock
BACKGROUND: To study whether the length of controlled ovarian stimulation affects in vitro fertilization (IVF) cycle outcomes. METHODS: This retrospective cohort study was performed at a private, university-affiliated fertility centre. We reviewed1522 IVF cycles, comprising 979 long gonadotropin-releasing hormone (GnRH) agonist and 543 GnRH antagonist protocols. All subjects underwent controlled ovarian stimulation followed by fresh embryo transfer. Logistic regression analysis was used to examine the relationship between trigger day and the following cycle outcomes: normal fertilization rate (FR), proportion of mature oocytes, proportion of cycles with embryos for cryopreservation, and clinical pregnancy rate (CPR)...
June 8, 2016: Minerva Ginecologica
Michael H Dahan, Lei Zhang, Hai Y Chen, Seang L Tan
BACKGROUND: Gonadotropin-releasing hormone agonist (GnRHa) triggering of final oocyte maturation has been used successfully in GnRH antagonist IVF cycles. It has not been used to date in cycles in which immature oocytes are matured in vitro. CASE: We report here for the first time that GnRHa triggering in a variation on the modified natural IVF cycle can be used as a strategy in the treatment of infertility secondary to polycystic ovary syndrome. In this approach, follicles were stimulated with gonadotropins for three to five days when they were small, and triggering of ovulation occurred when the largest follicles were 10 to 12 mm in diameter...
May 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Edson Borges, Daniela Paes Almeida Ferreira Braga, Amanda S Setti, Livia S Vingris, Rita Cássia S Figueira, Assumpto Iaconelli
OBJECTIVE: To compare the use of GnRH agonist (GnRHa) or hCG trigger in potential OHSS patients undergoing freeze-all programs. We also compared the clinical outcomes when fresh versus freeze-thawed embryo transfers were performed in cycles with a high number of retrieved oocytes. METHODS: The study included potential OHSS patients who received GnRHa (n=74) or hCG (n=49) trigger. The protocols were compared with respect to the clinical outcomes. We also compared the clinical outcomes of cycles in which hCG trigger was used and more than 20 MII oocytes were retrieved when: fresh embryo transfer protocol (n=153) or freeze-all protocol (n=123) were performed...
2016: JBRA Assisted Reproduction
Matthew T Connell, George Patounakis, Mae Wu Healy, Alan H DeCherney, Kate Devine, Eric Widra, Michael J Levy, Micah J Hill
OBJECTIVE: To compare the effect of P on live birth rate between hCG and GnRH agonist (GnRH-a) trigger cycles. DESIGN: Retrospective cohort study. SETTING: Large private assisted reproductive technology (ART) practice. PATIENT(S): A total of 3,326 fresh autologous ART cycles. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Live birth. RESULT(S): A total of 647 GnRH-a trigger cycles were compared with 2,679 hCG trigger cycles...
September 1, 2016: Fertility and Sterility
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