Abstract
Objective
To compare fertilization, implantation and pregnancy rates in donor oocyte cycles triggered for final oocyte maturation with either human chorionic gonadotropin (hCG) or gonadotropin releasing hormone (GnRH) agonist in the same donor population in two sequential stimulation cycles.
Design
Prospective randomized cross-over trial.
Setting
Private infertility clinic.
Patient(s)
Eighty-eight stimulation cycles in 44 egg donors.
Interventions
Controlled ovarian hyperstimulation (COH) with GnRH antagonist protocol triggered with hCG or GnRH agonist (leuprolide acetate 0.15 mg) in the same egg donors in two consecutive cycles.
Main outcome measure(s)
The primary outcome measure was the proportion of mature and fertilized oocytes per donor cycle. Secondary outcome measures were implantation and pregnancy rates in the recipients and incidence of ovarian hyperstimulation syndrome (OHSS) in oocyte donors.
Result(s)
The proportion of mature oocytes, fertilized oocytes and mean embryo scores were comparable between the two triggering agents. While implantation (36.53% vs, 32.93%), pregnancy (69.08% vs. 68.81%) and clinical pregnancy (41.3% vs. 40.2%) rates were comparable for the groups, the incidence of OHSS was significantly lower in GnRH than in hCG triggered cycles.
Conclusion(s)
Fertilization, implantation and pregnancy rates from donor oocytes stimulated with GnRH antagonist protocol were identical for donor cycles triggered with hCG and GnRH agonist. GnRH antagonist triggering in egg donors was associated with lower rates of OHSS.
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Acknowledgements
The authors thank Nevin Demir, Handan Canca and Cyprus Yasam Hospital IVF team for the data collection.
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This is the first prospective randomized cross-over study supporting the hypothesis that GnRH agonist is an effective alternative to hCG for the final oocyte maturation in oocyte donor cycles and should be the method of choice, especially for donors with evident risk factors for OHSS.
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Sismanoglu, A., Tekin, H.I., Erden, H.F. et al. Ovulation triggering with GnRH agonist vs. hCG in the same egg donor population undergoing donor oocyte cycles with GnRH antagonist: a prospective randomized cross-over trial. J Assist Reprod Genet 26, 251–256 (2009). https://doi.org/10.1007/s10815-009-9326-6
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DOI: https://doi.org/10.1007/s10815-009-9326-6