Shweta R Nayak1, Anthony N Wakim. 1. University of Pittsburgh Medical Center, Department of Obstetrics and Gynecology, 300 Halket Street, Pittsburgh, PA 15213, USA. nayaksr2@upmc.edu
Abstract
OBJECTIVE: To describe our experience with random-start IVF with the use of GnRH agonist for final oocyte maturation, to reduce the risk of ovarian hyperstimulation syndrome. DESIGN: Case series. SETTING: University-based center for reproductive endocrinology and infertility. PATIENT(S): Patients with a new diagnosis of cancer who presented with a narrow time frame for IVF before initiating cancer therapy. INTERVENTION(S): Random-start GnRH antagonist cycles with GnRH agonist trigger for final oocyte maturation. MAIN OUTCOME MEASURE(S): Number of oocytes retrieved, fertilization rate, rates of ovarian hyperstimulation syndrome. RESULTS: Cycles were started in the late follicular or luteal phase, and the duration of controlled ovarian hyperstimulation ranged between 8-13 days. A total of 14-40 oocytes were retrieved and 5-20 embryos cryopreserved for each patient. CONCLUSION(S): Random-start IVF is a reasonable option for fertility preservation in those cancer patients for whom the treatment window may be narrow. In addition, the use of a GnRH agonist for final oocyte maturation may decrease the potential risk of ovarian hyperstimulation syndrome.
OBJECTIVE: To describe our experience with random-start IVF with the use of GnRH agonist for final oocyte maturation, to reduce the risk of ovarian hyperstimulation syndrome. DESIGN: Case series. SETTING: University-based center for reproductive endocrinology and infertility. PATIENT(S): Patients with a new diagnosis of cancer who presented with a narrow time frame for IVF before initiating cancer therapy. INTERVENTION(S): Random-start GnRH antagonist cycles with GnRH agonist trigger for final oocyte maturation. MAIN OUTCOME MEASURE(S): Number of oocytes retrieved, fertilization rate, rates of ovarian hyperstimulation syndrome. RESULTS: Cycles were started in the late follicular or luteal phase, and the duration of controlled ovarian hyperstimulation ranged between 8-13 days. A total of 14-40 oocytes were retrieved and 5-20 embryos cryopreserved for each patient. CONCLUSION(S): Random-start IVF is a reasonable option for fertility preservation in those cancerpatients for whom the treatment window may be narrow. In addition, the use of a GnRH agonist for final oocyte maturation may decrease the potential risk of ovarian hyperstimulation syndrome.