Repeated Injection of GnRH Agonist for Triggering Final Oocyte Maturation in Patients at High Risk of Ovarian Hyperstimulation Syndrome in GnRH Antagonist Protocol
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 80
- 试验地点
- 1
- 主要终点
- Oocyte maturity
研究概览
简要总结
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 repeated injection of GnRH agonist for preventing OHSS and maintaining clinical outcome in high risk patients who receive controlled ovarian stimulation in GnRH antagonist protocol.
详细描述
This was a prospective cohort study of all women attending the Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Nanfang Hospital, affiliated with Southern Medical University for in vitro fertilization and/or intracytoplasmic sperm injection . Women at high risk of OHSS who received IVF and/or intracytoplasmic sperm injection (ICSI) treatment with a flexible GnRH antagonist protocol were recruited to participate in this study.
All patients underwent standard ovarian stimulation protocol with gonadotropins, standard individualized adjustment of medication dose, and standard egg retrieval procedure. Patients were triggered with a single bolus of 0.2 mg triptorelin at night and had second injection of 0.2 mg triptorelin 12 hours later when the criteria for administration of the ovulation trigger were met.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- — 至 40 Years（Child, Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •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
排除标准
- •patients undergoing coasting
- •patients with past ovarian surgery
研究组 & 干预措施
Repeated GnRHa
Patients were triggered with repeated GnRHa
干预措施: triptorelin (Drug)
结局指标
主要结局
Oocyte maturity
时间窗: 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 ICSI.
clinical pregnancy rate per transfer cycle
时间窗: 1month post embryo transfer
numbers of patients having OHSS
时间窗: 2 weeks post trigger with repeated GnRHa
oocyte yield
时间窗: oocyte retrieval day (34 to 38 hours post the first trigger with GnRHa)
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.
次要结局
- serum luteinizing hormone level 12 hours post first trigger(12 hours post trigger with the first injection of GnRHa)
- serum luteinizing hormone level 24 hours post first trigger(24 hours post the first injection of GnRHa)
- fertilization rate(48 hours post IVF/ICSI)
- implantation rate(1 month post embryo transfer)
研究者
Chenshiling
Professor, M.D., Ph.D.
Nanfang Hospital, Southern Medical University