Itai Bar-Hava1, Yossi Mizrachi2, Daphne Karfunkel-Doron3, Yeela Omer3, Liron Sheena3, Nurit Carmon3, Gila Ben-David4. 1. Fertility Center From A to Z, Ramat Aviv, Israel; IVF Unit, Assuta Medical Center, Rishon Lezion, Israel. Electronic address: barhava@gmail.com. 2. Department of Obstetrics & Gynecology, Edith Wolfson Medical Center, Holon, Israel. 3. Fertility Center From A to Z, Ramat Aviv, Israel. 4. Fertility Center From A to Z, Ramat Aviv, Israel; IVF Unit, Assuta Medical Center, Rishon Lezion, Israel.
Abstract
OBJECTIVE: To study whether intranasal GnRH agonist (GnRHa) can be effectively used for luteal support in high-responder patients undergoing fresh-embryo transfer after ovulation induction with the use of GnRHa. DESIGN: Retrospective cohort study. SETTING: Private fertility clinic. PATIENT(S): Forty-six high-responder patients were administered a GnRHa ovulation trigger to avoid ovarian hyperstimulation syndrome (OHSS), followed by 2 weeks of daily intranasal GnRHa (nafarelin) for luteal-phase support. No additional progesterone supplementation was administrated. INTERVENTION(S): Intranasal GnRHa for luteal-phase support. MAIN OUTCOME MEASURE(S): The primary outcome was ongoing clinical pregnancy rate. RESULT(S): High median progesterone levels were measured at midluteal phase and on the day of the first positive pregnancy test (190 nmol/L on both measures). We obtained 24 (52.1%) ongoing clinical pregnancies. None of the patients developed OHSS. CONCLUSION(S): Intranasal GnRHa is effective in achieving luteal-phase support in high-responder patients triggered with GnRHa and avoiding OHSS.
OBJECTIVE: To study whether intranasal GnRH agonist (GnRHa) can be effectively used for luteal support in high-responder patients undergoing fresh-embryo transfer after ovulation induction with the use of GnRHa. DESIGN: Retrospective cohort study. SETTING: Private fertility clinic. PATIENT(S): Forty-six high-responder patients were administered a GnRHa ovulation trigger to avoid ovarian hyperstimulation syndrome (OHSS), followed by 2 weeks of daily intranasal GnRHa (nafarelin) for luteal-phase support. No additional progesterone supplementation was administrated. INTERVENTION(S): Intranasal GnRHa for luteal-phase support. MAIN OUTCOME MEASURE(S): The primary outcome was ongoing clinical pregnancy rate. RESULT(S): High median progesterone levels were measured at midluteal phase and on the day of the first positive pregnancy test (190 nmol/L on both measures). We obtained 24 (52.1%) ongoing clinical pregnancies. None of the patients developed OHSS. CONCLUSION(S): Intranasal GnRHa is effective in achieving luteal-phase support in high-responder patients triggered with GnRHa and avoiding OHSS.
Authors: Barbara Lawrenz; Nicolas Garrido; Suzan Samir; Francisco Ruiz; Laura Melado; Human M Fatemi Journal: PLoS One Date: 2017-05-01 Impact factor: 3.240
Authors: Francesco M Fusi; Claudio M Brigante; Laura Zanga; Mario Mignini Renzini; Chiara Bosisio; Rubens Fadini Journal: Reprod Biol Endocrinol Date: 2019-11-29 Impact factor: 5.211