scholarly journals New protocol for commencing the GnRH antagonist in assisted conception treatment cycles: elimination of the premature LH surge with similar pregnancy rates

2004 ◽  
Vol 44 (6) ◽  
pp. 565-570 ◽  
Author(s):  
Andreas Mavrides ◽  
Stuart Lavery ◽  
Geoffrey Trew
Keyword(s):  
Gnrh Antagonist ◽  
Pregnancy Rates ◽  
Assisted Conception ◽  
Lh Surge ◽  
Premature Lh Surge

scholarly journals GnRH antagonist-induced inhibition of the premature LH surge increases pregnancy rates in IUI-stimulated cycles. A prospective randomized trial

2006 ◽  
Vol 22 (1) ◽  
pp. 101-108 ◽  
Author(s):  
A. Allegra ◽  
A. Marino ◽  
F. Coffaro ◽  
P. Scaglione ◽  
F. Sammartano ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Gnrh Antagonist ◽  
Pregnancy Rates ◽  
Prospective Randomized Trial ◽  
Lh Surge ◽  
Premature Lh Surge

P–685 Luteinization after final oocyte maturation induction is not compromised in women that receive double dose of Gonadotrophin-releasing hormone antagonists during controlled ovarian hyperstimulation

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M Luna ◽  
T Alkon ◽  
D Cassis ◽  
C Hernandez-nieto ◽  
B Sandler
Keyword(s):  
Oocyte Maturation ◽  
Gnrh Antagonist ◽  
Controlled Ovarian Hyperstimulation ◽  
Ovarian Hyperstimulation ◽  
Double Dose ◽  
Gnrh Antagonists ◽  
Lh Surge ◽  
Final Oocyte Maturation ◽  
Serum Hormone ◽  
Premature Lh Surge

Abstract Study question Does the use of double dose of GnRH antagonists during COH in women with risk of premature LH surge alter luteinization after final oocyte maturation induction? Summary answer The use of double dose of GnRH antagonist in women with risk of premature luteinizing hormone surge dosent affect luteinization after final oocyte maturation induction. What is known already GnRH antagonists are used to prevent a premature LH surge during controlled ovarian hyperstimulation. The antagonists directly inhibit gonadotrophin release within several hours through competitive binding to pituitary GnRH receptors, producing a rapid suppression of LH and FSH, with no initial flare effect. In women with diminished ovarian reserve (DOR) it is not uncommon that premature luteinization cannot be completely prevented using a daily dose GnRH antagonist. To date, no study has evaluated the effects of using a daily double dose of GnRH antagonists to prevent a premature LH surge and its effect on luteinization after final oocyte maturation induction. Study design, size, duration This monocentric retrospective analysis evaluated the effect on luteinization after final oocyte maturation induction in twenty women during COH who received a daily double dose of GnRH antagonists (Cetrotide 0.25 mg/mL, Merck) from January 2020 to December 2020. Participants/materials, setting, methods Women with severe DOR and history of premature luteinization during COH received a double dose of GnRH antagonist when the leading follicle reached 12–14 mm (am and pm). When two follicles reached ≥18 mm in diameter, final oocyte maturation was induced with dual trigger using Leuprolide acetate and hCG. Progesterone, estradiol, bHCG, and LH levels were measured the day after final oocyte maturation induction to assure adequate luteinization. Main results and the role of chance In total twenty women were included in the analysis. Mean age 36.8± 4.2, AMH 0.65± 0.32 ng/ml, baseline antral follicle count 4± 2.3, serum hormone levels the day of ovulation induction trigger: progesterone 0.89± 0.34 ng/ml, LH 1.6± 2.1 ng/ml, estradiol 1235 ± 1420 pg/ml. Post-surge serum hormone levels average reached adequate levels: estradiol 1645 ± 1116 pg/ml, progesterone 20.4 ±2.2 ng/ml, LH 62.66± 10.5 IU/ml and, bHCG 247±115 IU/ml. A total of 76 oocytes were retrieved (3.8± 0.8 oocytes per patient), 63.1% (48/76) MII, 22% (17/76) MI, 14% (11/76) GV. Limitations, reasons for caution The retrospective nature of the study, small sample size, and potential variability in the study center’s laboratory protocol(s) compared to other reproductive treatment centers may limit the external validity of our findings. Wider implications of the findings: The daily use of double dose of GnRH antagonists during COH offers the possibility of preventing a premature LH surge in women with DOR with high risk of early ovulation, without compromising luteinization after final oocyte maturation induction. Trial registration number NA

scholarly journals Progestin primed ovarian stimulation using corifollitropin alfa in PCOS women effectively prevents LH surge and reduces injection burden compared to GnRH antagonist protocol

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ting-Chi Huang ◽  
Mei-Zen Huang ◽  
Kok-Min Seow ◽  
Ih-Jane Yang ◽  
Song-Po Pan ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Gnrh Agonist ◽  
Ovarian Stimulation ◽  
Gnrh Antagonist ◽  
Polycystic Ovary ◽  
Implantation Rate ◽  
Live Birth Rate ◽  
Lh Surge ◽  
Corifollitropin Alfa ◽  
Premature Lh Surge

AbstractUtilizing corifollitropin alfa in GnRH antagonist (GnRHant) protocol in conjunction with GnRH agonist trigger/freeze-all strategy (corifollitropin alfa/GnRHant protocol) was reported to have satisfactory outcomes in women with polycystic ovary syndrome (PCOS). Although lessening in gonadotropin injections, GnRHant were still needed. In addition to using corifollitropin alfa, GnRHant was replaced with an oral progestin as in progestin primed ovarian stimulation (PPOS) to further reduce the injection burden in this study. We try to investigate whether this regimen (corifollitropin alfa/PPOS protocol) could effectively reduce GnRHant injections and prevent premature LH surge in PCOS patients undergoing IVF/ICSI cycles. This is a retrospective cohort study recruiting 333 women with PCOS, with body weight between 50 and 70 kg, undergoing first IVF/ICSI cycle between August 2015 and July 2018. We used corifollitropin alfa/GnRHant protocol prior to Jan 2017 (n = 160), then changed to corifollitropin alfa/PPOS protocol (n = 173). All patients received corifollitropin alfa 100 μg on menstruation day 2/3 (S1). Additional rFSH was administered daily from S8. In corifollitropin alfa/GnRHant group, cetrorelix 0.25 mg/day was administered from S5 till the trigger day. In corifollitropin alfa/PPOS group, dydrogesterone 20 mg/day was given from S1 till the trigger day. GnRH agonist was used to trigger maturation of oocyte. All good quality day 5/6 embryos were frozen, and frozen-thawed embryo transfer (FET) was performed on subsequent cycle. A comparison of clinical outcomes was made between the two protocols. The primary endpoint was the incidence of premature LH surge and none of the patients occurred. Dydrogesterone successfully replace GnRHant to block LH surge while an average of 6.8 days of GnRHant injections were needed in the corifollitropin alfa/GnRHant group. No patients suffered from ovarian hyperstimulation syndrome (OHSS). The other clinical outcomes including additional duration/dose of daily gonadotropin administration, number of oocytes retrieved, and fertilization rate were similar between the two groups. The implantation rate, clinical pregnancy rate, and live birth rate in the first FET cycle were also similar between the two groups. In women with PCOS undergoing IVF/ICSI treatment, corifollitropin alfa/PPOS protocol could minimize the injections burden with comparable outcomes to corifollitropin alfa/GnRHant protocol.

scholarly journals Dose-Dependent Chlormadinone Acetate Can Suppress Premature LH Surge in Parallel with LH Value Reduction

2020 ◽  
Vol 02 (01) ◽  
pp. 21-26
Author(s):  
Yuya Takeshige ◽  
Tomoko Hashimoto ◽  
Koichi Kyono
Keyword(s):  
Ovarian Stimulation ◽  
Gnrh Antagonist ◽  
Cost Effective ◽  
Human Menopausal Gonadotropin ◽  
Retrospective Case ◽  
Lh Surge ◽  
Chlormadinone Acetate ◽  
Appropriate Treatment ◽  
Premature Lh Surge ◽  
Dose Dependent

Background: Progestin-primed ovarian stimulation (PPOS) protocol is reported as an alternative method of premature luteinizing hormone (LH) surge suppression. How much dosage of chlormadinone acetate (CMA), a synthetic progestin, is appropriate treatment for this phenomenon? Methods: Retrospective case control study was performed at private assisted reproductive technology (ART) clinic in Japan. Collected data was 231 cycles in patients who underwent either PPOS protocol using 12, 6, 4, or 2 mg of CMA, groups 6C, 3C, 2C, and 1C, respectively (total, 113 cycles), or gonadotropin-releasing hormone (GnRH) antagonist protocol, groups 6A, 3A, 2A, and 1A, respectively (total, 118 cycles). In the CMA group, CMA and human menopausal gonadotropin (hMG) or follicle-stimulating hormone (FSH) were administered simultaneously beginning on menstrual cycle day 3. Serum P, E2, and LH were determined on the day of human chorionic gonadotropin (hCG) administration. Occurrence of premature LH surge was compared between two groups. Pregnancy outcomes were also calculated. Results: Premature LH surge was completely suppressed in CMA groups 6C, 3C, and 2C. On the other hand, this phenomenon was detected in antagonist method groups (5.9%, 7/118). But spontaneous ovulation was not observed in any group, and clinical outcomes are equal to those of GnRH antagonist treatment. Conclusions: Controlled ovarian stimulation (COS) using CMA can be an appropriate alternative progestin for PPOS protocol. Since CMA is an oral medication, this method can be easy to conduct and cost-effective compared with the antagonist method. From our observation, we suggest 4 mg/day of CMA can control the egg retrieval cycle without LH surge occurrence as in other PPOS methods.

Effectiveness of GnRH Antagonist Use in PCOS Patients With Repeated Premature LH Surge in Patients Undergoing IUI Cycles

2005 ◽  
Vol 84 ◽  
pp. S303 ◽  
Author(s):  
O. Taskin ◽  
M. Erman Akar ◽  
S. Kursun ◽  
Z. Salar ◽  
T. Gunduz ◽  
...  
Keyword(s):  
Gnrh Antagonist ◽  
Lh Surge ◽  
Premature Lh Surge

scholarly journals Comparison of Dydrogesterone and GnRH Antagonists for Prevention of Premature LH Surge in IVF/ICSI Cycles: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Batool Hossein Rashidi ◽  
Azam Tarafdari ◽  
Seyedeh Tahereh Ghazimirsaeed ◽  
Ensieh Shahrokh Tehraninezhad ◽  
Fatemeh Keikha ◽  
...  
Keyword(s):  
Gnrh Antagonist ◽  
Controlled Trial ◽  
Intervention Group ◽  
Clinical Pregnancy ◽  
Control Group ◽  
Gnrh Antagonists ◽  
Lh Surge ◽  
Randomized Controlled ◽  
Premature Lh Surge ◽  
And Control

Objective: To compare the effect of dydrogesterone and GnRH antagonists on prevention of premature luteinizing hormone (LH) surge and pregnancy outcomes in infertile women undergoing IVF/ICSI. Materials and methods: In a Randomized controlled trial (RCT), two-hundred eligible women undergoing in vitro fertilization (IVF) /intracytoplasmic sperm injection (ICSI) treatment were randomly assigned into two groups. Human menopausal gonadotropin (HMG) was administered for controlled ovarian stimulation (COS) in both groups. Intervention group (group 1) received 20 mg dydrogesterone from day 2 of menstrual cycle till trigger day and control group (group2) received GnRH antagonist from the day that leading follicle reached 13 mm in diameter till trigger day. Serum levels of LH, estradiol and progesterone were measured on the trigger day. The primary outcome measure was the incidence of a premature LH surge, and the secondary outcomes investigated were the chemical and clinical pregnancy rates in the first FET cycles. Results: There were no significant differences in patients' age, BMI, AMH levels, previous IVF cycle, and cause of infertility between the two groups. None of the patients in two groups experienced a premature luteinizing hormone surge. The numbers of retrieved oocytes, the MII oocytes and good quality embryos, were significantly higher in the intervention group than antagonist group (p < 0.05). The overall chemical pregnancy rate in intervention group (43/91: 46.2%) and control group (45/91: 49.5%) (p = 0.820) was similar. Meanwhile, the clinical pregnancy rate was similar between groups too. Conclusion: Regarding the cost, efficacy and easy usage of dydrogestrone, it may be reasonable to use it as an alternative to GnRH antagonist for the prevention of premature LH surge.

scholarly journals Short, semi-short or long GnRH agonist treatment regimens in women ICSI candidate; which is proper in preventing premature LH surge?

2016 ◽  
Vol 21 (3) ◽  
pp. 161-167
Author(s):  
Popea Rezaeian ◽  
Sedighe Esmaeilzadeh ◽  
Zahra Tajali ◽  
Fateme Nadi Heidari ◽  
Masoumeh Golsorkhtabaramiri
Keyword(s):  
Gnrh Agonist ◽  
Lh Surge ◽  
Treatment Regimens ◽  
Premature Lh Surge

A Short Ovarian Stimulation Does Not Negatively Impact IVF Pregnancy Rates When Utilizing a GnRH Antagonist Protocol

2005 ◽  
Vol 84 ◽  
pp. S251-S252
Author(s):  
J.L. Eaton ◽  
A. Zimon ◽  
T. Von Wald ◽  
M. Goldman ◽  
M.M. Alper ◽  
...  
Keyword(s):  
Ovarian Stimulation ◽  
Gnrh Antagonist ◽  
Pregnancy Rates ◽  
Gnrh Antagonist Protocol ◽  
Antagonist Protocol

scholarly journals Estradiol use in the luteal phase and its effects on pregnancy rates in IVF cycles with GnRH antagonist: a systematic review

2017 ◽  
Vol 21 (3) ◽  
Author(s):  
Lanna Marla Andrade Pinheiro ◽  
Priscilla da Silva Cândido ◽  
Tássia Camila Moreto ◽  
Wanessa Gonzaga Di Almeida ◽  
Eduardo Camelo de Castro
Keyword(s):  
Systematic Review ◽  
Luteal Phase ◽  
Gnrh Antagonist ◽  
Pregnancy Rates
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