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. RESULTS: A decreased serum estradiol level, a decreased number of retrieved oocytes, an increased MII retrieved rate, and decreased fertilization rate was observed in the hCG when compared with the GnRHa group. No significant differences were noted concerning clinical outcomes. When fresh cycles were compared with frozen-thawed cycles, the estradiol serum level and the number of cryopreserved embryos were higher in the frozen-thawed cycles. The clinical pregnancy rate was higher among freeze-all cycles, as well as the implantation and cumulative pregnancy rates, when compared with fresh embryo transfer cycles. CONCLUSION: The use of GnRHa trigger may be a good alternative to prevent the OHSS in patients presenting an extreme ovarian response to COS, leading to similar clinical outcomes, when compared with the traditional hCG trigger. Moreover, our findings demonstrated that the strategy of freezing-all embryos not only decreases the risk of OHSS but also leads to a better pregnancy rate.
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. RESULTS: A decreased serum estradiol level, a decreased number of retrieved oocytes, an increased MII retrieved rate, and decreased fertilization rate was observed in the hCG when compared with the GnRHa group. No significant differences were noted concerning clinical outcomes. When fresh cycles were compared with frozen-thawed cycles, the estradiol serum level and the number of cryopreserved embryos were higher in the frozen-thawed cycles. The clinical pregnancy rate was higher among freeze-all cycles, as well as the implantation and cumulative pregnancy rates, when compared with fresh embryo transfer cycles. CONCLUSION: The use of GnRHa trigger may be a good alternative to prevent the OHSS in patients presenting an extreme ovarian response to COS, leading to similar clinical outcomes, when compared with the traditional hCG trigger. Moreover, our findings demonstrated that the strategy of freezing-all embryos not only decreases the risk of OHSS but also leads to a better pregnancy rate.
Authors: Evangelos G Papanikolaou; Evi Timotheou; Petroula Tatsi; Hieronymus Janssens; Michael Grynberg; Apostolos Athanasiadis; Christina Zafeirati; Robert Najdecki; Stamatios Petousis Journal: Int J Fertil Steril Date: 2018-10-02
Authors: The Eshre Guideline Group On Ovarian Stimulation; Ernesto Bosch; Simone Broer; Georg Griesinger; Michael Grynberg; Peter Humaidan; Estratios Kolibianakis; Michal Kunicki; Antonio La Marca; George Lainas; Nathalie Le Clef; Nathalie Massin; Sebastiaan Mastenbroek; Nikolaos Polyzos; Sesh Kamal Sunkara; Tanya Timeva; Mira Töyli; Janos Urbancsek; Nathalie Vermeulen; Frank Broekmans Journal: Hum Reprod Open Date: 2020-05-01
Authors: Kjersti Westvik-Johari; Liv Bente Romundstad; Deborah A Lawlor; Christina Bergh; Mika Gissler; Anna-Karina A Henningsen; Siri E Håberg; Ulla-Britt Wennerholm; Aila Tiitinen; Anja Pinborg; Signe Opdahl Journal: PLoS Med Date: 2021-06-25 Impact factor: 11.069