Document Detail


The luteal phase after GnRH-agonist triggering of ovulation: present and future perspectives.
MedLine Citation:
PMID:  22197130     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In stimulated IVF/intracytoplasmic sperm injection cycles, the luteal phase is disrupted, necessitating luteal-phase supplementation. The most plausible reason behind this is the ovarian multifollicular development obtained after ovarian stimulation, resulting in supraphysiological steroid concentrations and consecutive inhibition of LH secretion by the pituitary via negative feedback at the level of the hypothalamic-pituitary axis. With the introduction of the gonadotrophin-releasing hormone-(GnRH) antagonist, an alternative to human chorionic gonadotrophin triggering of final oocyte maturation is the use of GnRH agonist (GnRHa) which reduces or even prevents ovarian hyperstimulation syndrome (OHSS). Interestingly, the current regimens of luteal support after HCG triggering are not sufficient to secure the early implanting embryo after GnRHa triggering. This review discusses the luteal-phase insufficiency seen after GnRHa triggering and the various trials that have been performed to assess the most optimal luteal support in relation to GnRHa triggering. Although more research is needed, GnRHa triggering is now an alternative to HCG triggering, combining a significant reduction in OHSS with high ongoing pregnancy rates.
Authors:
Peter Humaidan; E G Papanikolaou; D Kyrou; B Alsbjerg; N P Polyzos; P Devroey; Human M Fatemi
Publication Detail:
Type:  Journal Article; Review     Date:  2011-11-09
Journal Detail:
Title:  Reproductive biomedicine online     Volume:  24     ISSN:  1472-6491     ISO Abbreviation:  Reprod. Biomed. Online     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-06     Completed Date:  2012-05-29     Revised Date:  2012-07-27    
Medline Journal Info:
Nlm Unique ID:  101122473     Medline TA:  Reprod Biomed Online     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  134-41     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
Affiliation:
The Fertility Clinic, Odense University Hospital, Odense, Denmark. peter.humaidan@ouh.regionsyddanmark.dk
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MeSH Terms
Descriptor/Qualifier:
Buserelin / therapeutic use*
Chorionic Gonadotropin / therapeutic use
Clomiphene / therapeutic use
Embryo Implantation / drug effects
Female
Gonadotropin-Releasing Hormone / agonists*,  antagonists & inhibitors
Humans
Luteal Phase / drug effects,  physiology*
Luteinizing Hormone / deficiency,  secretion
Narcotic Antagonists / therapeutic use
Oocyte Retrieval / methods
Ovarian Hyperstimulation Syndrome / prevention & control
Ovulation Induction / methods*
Pregnancy
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin; 0/Narcotic Antagonists; 33515-09-2/Gonadotropin-Releasing Hormone; 57982-77-1/Buserelin; 9002-67-9/Luteinizing Hormone; 911-45-5/Clomiphene
Comments/Corrections
Comment In:
Reprod Biomed Online. 2012 Jun;24(6):680-1; author reply 682-3   [PMID:  22503268 ]

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


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