Document Detail


Triggering ovulation with gonadotropin-releasing hormone agonist in in vitro fertilization patients with polycystic ovaries does not cause ovarian hyperstimulation syndrome despite very high estradiol levels.
MedLine Citation:
PMID:  19200978     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether inducing ovulation with a GnRH agonist in patients with polycystic ovaries (PCO) would permit oocyte retrieval without the burden or risk of cancellation, coasting, or ovarian hyperstimulation syndrome (OHSS), thus maintaining pregnancy rates by allowing embryo cryopreservation for transfer in a subsequent cycle.
DESIGN: Retrospective observational study.
SETTING: Private institution.
PATIENT(S): Forty-two women who had previously experienced a controlled ovarian hyperstimulation (COH)/IVF cycle that had to be cancelled because of an elevated risk of OHSS.
INTERVENTION(S): Forty-two PCO patients with a previous cancelled IVF cycle were assigned to a second controlled ovarian stimulation with recombinant FSH (75-150 IU/day) + GnRH antagonist (0.25 mg/day). Embryos were cryopreserved and transferred in a later cycle.
MAIN OUTCOME MEASURE(S): OHSS, oocyte retrieval, and pregnancy rates.
RESULT(S): In the first COH, the cycle had to be cancelled to avoid OHSS because E(2) serum levels were above safety levels (4809.6 +/- 2947.7). However, in the second cycle (ovulation triggered with a GnRH agonist) and independent of E(2) serum levels (4518.5 +/- 2118.85), all PCO patients eventually completed oocyte retrieval and frozen ET. With regard to pregnancy rates, 33% of patients receiving a transfer of a previously frozen embryo were successful. No patient developed OHSS.
CONCLUSION(S): Triggering ovulation with a GnRH agonist followed by embryo cryopreservation allows PCO patients to complete a COH/IVF cycle with no cycle cancellation, coasting, or OHSS and, finally, to attain good pregnancy rates.
Authors:
Maria A Manzanares; Jose Lui Gómez-Palomares; Elisabetta Ricciarelli; Eleuterio R Hernández
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-02-06
Journal Detail:
Title:  Fertility and sterility     Volume:  93     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-01     Completed Date:  2010-04-01     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1215-9     Citation Subset:  IM    
Copyright Information:
Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Affiliation:
Clinica FivMadrid, Juan Alvarez de Mendizabal, 28008 Madrid, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adult
Estradiol / biosynthesis,  blood*
Female
Fertilization in Vitro / adverse effects,  methods
Follicle Stimulating Hormone / adverse effects,  pharmacology,  therapeutic use
Gonadotropin-Releasing Hormone / administration & dosage,  agonists*,  analogs & derivatives,  blood*
Humans
Ovarian Hyperstimulation Syndrome / blood*,  chemically induced
Ovulation Induction* / methods
Polycystic Ovary Syndrome / blood*,  drug therapy
Pregnancy
Recombinant Proteins / adverse effects,  pharmacology,  therapeutic use
Retrospective Studies
Chemical
Reg. No./Substance:
0/Recombinant Proteins; 33515-09-2/Gonadotropin-Releasing Hormone; 50-28-2/Estradiol; 9002-68-0/Follicle Stimulating Hormone; OON1HFZ4BA/cetrorelix

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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