Gonadotropin-releasing hormone agonist to induce final oocyte maturation prevents the development of ovarian hyperstimulation syndrome in high-risk patients and leads to improved clinical outcomes compared with coasting

Andrea J DiLuigi; Lawrence Engmann; David W Schmidt; Donald B Maier; John C Nulsen; Claudio A Benadiva

doi:10.1016/j.fertnstert.2009.10.034

Gonadotropin-releasing hormone agonist to induce final oocyte maturation prevents the development of ovarian hyperstimulation syndrome in high-risk patients and leads to improved clinical outcomes compared with coasting

Fertil Steril. 2010 Aug;94(3):1111-4. doi: 10.1016/j.fertnstert.2009.10.034. Epub 2010 Jan 13.

Authors

Andrea J DiLuigi¹, Lawrence Engmann, David W Schmidt, Donald B Maier, John C Nulsen, Claudio A Benadiva

Affiliation

¹ The Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, University of Connecticut Health Center, Farmington, Connecticut 06030-6224, USA. [email protected]

PMID: 20074722
DOI: 10.1016/j.fertnstert.2009.10.034

Abstract

Ninety-four women undergoing IVF with peak E2 level>4000 pg/mL received leuprolide acetate (LA) trigger (LA trigger group) or had gonadotropins withheld for one or more days (coasting group) followed by hCG trigger, unless cycle cancellation occurred. There were no cases of ovarian hyperstimulation syndrome in either group, and the LA trigger group had significantly more oocytes retrieved (26.9+/-9.5 vs. 17.7+/-9.3) P<0.001, more normally fertilized oocytes (15.0+/-7.8 vs. 10.3+/-6.3) P=0.01, and higher clinical and ongoing pregnancy rates than the coasting group (52.5% vs. 27.2%; 49.2% vs. 24.2%, P=0.02 for both comparisons, respectively).

Publication types

Evaluation Study

MeSH terms

Adult
Drug Administration Schedule
Estradiol / blood
Female
Fertility Agents, Female / administration & dosage
Fertility Agents, Female / adverse effects
Fertility Agents, Female / pharmacology
Gonadotropin-Releasing Hormone / agonists
Humans
Leuprolide / administration & dosage*
Leuprolide / adverse effects
Leuprolide / pharmacology*
Oocytes / drug effects*
Oocytes / physiology
Oogenesis / drug effects
Ovarian Hyperstimulation Syndrome / blood
Ovarian Hyperstimulation Syndrome / etiology
Ovarian Hyperstimulation Syndrome / prevention & control*
Pregnancy
Pregnancy Rate
Retrospective Studies
Risk Factors
Treatment Outcome
Withholding Treatment*

Substances

Fertility Agents, Female
Gonadotropin-Releasing Hormone
Estradiol
Leuprolide