Dual Trigger With GnRH Agonist and Human Chorionic Gonadotropin for Final Oocyte Maturation in Patients at High Risk of Ovarian Hyperstimulation Syndrome in GnRH Antagonist Protocol
Overview
- Phase
- Not Applicable
- Intervention
- hCG
- Conditions
- Infertility and at High Risk of OHSS
- Sponsor
- Chenshiling
- Enrollment
- 200
- Locations
- 1
- Primary Endpoint
- numbers of patients having OHSS
- Last Updated
- 12 years ago
Overview
Brief Summary
Gonadotropin releasing hormone (GnRH) agonist is sufficient for triggering final oocyte maturation in GnRH antagonist protocol and can significantly reduce incidence of ovarian hyperstimulation syndrome (OHSS) in high-risk patients.
However, lower oocyte yield was reported in patients with lower luteinizing hormone (LH) level post trigger with single injection of GnRH agonist, which might be related to the shorter duration and lower amount of LH induced by GnRH agonist.
Our aim is to study dual trigger with GnRH agonist and human chorionic gonadotropin (hCG) for preventing OHSS and maintaining clinical outcome in high risk patients who receive controlled ovarian stimulation in GnRH antagonist protocol.
Investigators
Chenshiling
Professor, M.D., Ph.D.
Nanfang Hospital, Southern Medical University
Eligibility Criteria
Inclusion Criteria
- •patients with polycystic ovarian syndrome
- •patients with polycystic ovarian morphology on ultrasound
- •patients who previously experienced an ovarian stimulation cycle, with a high response to gonadotrophins
Exclusion Criteria
- •patients undergoing coasting
- •patients with past ovarian surgery
Arms & Interventions
0.2mg triptorelin and 1000 IU hCG
Patients were triggered with 0.2mg triptorelin and 1000 IU hCG
Intervention: hCG
0.2mg triptorelin and 500 IU hCG
Patients were triggered with 0.2mg triptorelin and 500 IU hCG
Intervention: triptorelin
0.2mg triptorelin and 500 IU hCG
Patients were triggered with 0.2mg triptorelin and 500 IU hCG
Intervention: hCG
0.2mg triptorelin and 1000 IU hCG
Patients were triggered with 0.2mg triptorelin and 1000 IU hCG
Intervention: triptorelin
Outcomes
Primary Outcomes
numbers of patients having OHSS
Time Frame: 2 weeks post trigger with dual GnRHa
clinical pregnancy rate per transfer cycle
Time Frame: 1month post embryo transfer
oocyte yield
Time Frame: oocyte retrieval day (34 to 38 hours post trigger with GnRHa and hCG)
Oocyte yield was defined as the ratio of the total number of collected oocytes to the number of follicles measuring ≥10 mm on the day of oocyte retrieval.
Oocyte maturity
Time Frame: 24 hours post oocyte retrieval day
Oocyte maturity was defined as the ratio of metaphase II (MII) oocytes to the number of collected oocytes in the patients undergoing with intracytoplasmic sperm injection (ICSI).
Secondary Outcomes
- serum hCG level 12 hours post trigger(12 hours post trigger)
- fertilization rate(48 hours post IVF/ICSI)
- implantation rate(1 month post embryo transfer)
- serum luteinizing hormone level 12 hours post trigger(12 hours post trigger)