HCG Trigger After Failed GnRH Agonist Trigger Resulted in Two Consecutive Live Births: A Case Report

Background: Failed gonadotropin-releasing hormone (GnRH) agonist trigger with no oocyte retrieved during aspiration of several follicles is a rare but recurrent situation that can be rescued by the termination of the aspiration procedure, retriggering by human chorion gonadotropin (hCG), and repeated oocyte pickup 36 h later. Failed GnRH agonist trigger is frustrating and unsatisfactory, and fertility doctors must be aware of possible hCG retriggering and retained opportunity for successful cycle outcome.Objective: In this case report, we present a woman who experienced failed GnRH agonist trigger and rescue hCG retrigger followed by two consecutive live births after frozen-thawed single blastocyst transfers.Methods: A case report.Results: Two healthy children were born in 2018 and 2020, respectively as a result of controlled ovarian stimulation for IVF, failed GnRH agonist trigger followed by hCG re-trigger, and successful retrieval of 25 oocytes.Conclusion: Retriggering with hCG after failed GnRH agonist trigger can result in consecutive live births, and such knowledge can prevent cycle cancellation and patient discouragement. Knowledge on retriggering with hCG and consecutive live births after failed GnRH agonist trigger can prevent cycle cancellation and patient discouragement.

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Retrospective comparison of GnRH agonist trigger with HCG trigger in GnRH antagonist cycles in anticipated high-responders

Reproductive BioMedicine Online ◽

10.1016/j.rbmo.2014.08.006 ◽

2014 ◽

Vol 29 (5) ◽

pp. 552-558 ◽

Cited By ~ 5

Author(s):

Adrija Kumar Datta ◽

Abey Eapen ◽

Heidi Birch ◽

Anitha Kurinchi-Selvan ◽

Gillian Lockwood

Keyword(s):

Gnrh Agonist ◽

Gnrh Antagonist ◽

Retrospective Comparison ◽

Gnrh Agonist Trigger ◽

High Responders ◽

Agonist Trigger ◽

Hcg Trigger

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Empty follicle syndrome after GnRH agonist trigger, rescued with HCG in a donor oocyte with successful pregnancy outcome: a case report

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20160410 ◽

2016 ◽

pp. 549-551

Author(s):

Akshaya Mahapatro ◽

Kundavi Shankar ◽

Thankam Varma

Keyword(s):

Case Report ◽

Pregnancy Outcome ◽

Gnrh Agonist ◽

Successful Pregnancy ◽

Donor Oocyte ◽

Empty Follicle Syndrome ◽

Gnrh Agonist Trigger ◽

Agonist Trigger

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GnRH Agonist Trigger and LH Activity Luteal Phase Support versus hCG Trigger and Conventional Luteal Phase Support in Fresh Embryo Transfer IVF/ICSI Cycles—A Systematic PRISMA Review and Meta-analysis

Frontiers in Endocrinology ◽

10.3389/fendo.2017.00116 ◽

2017 ◽

Vol 8 ◽

Cited By ~ 23

Author(s):

Thor Haahr ◽

Matheus Roque ◽

Sandro C. Esteves ◽

Peter Humaidan

Keyword(s):

Embryo Transfer ◽

Gnrh Agonist ◽

Luteal Phase ◽

Meta Analysis ◽

Fresh Embryo Transfer ◽

Luteal Phase Support ◽

Gnrh Agonist Trigger ◽

Agonist Trigger ◽

Hcg Trigger

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GnRH-Agonist Trigger versus Human Chorionic Gonadotrophin (HCG) Trigger in Cases of Controlled Ovarian Stimulation; Randomized Controlled Trial

Open Journal of Obstetrics and Gynecology ◽

10.4236/ojog.2021.1111135 ◽

2021 ◽

Vol 11 (11) ◽

pp. 1452-1460

Author(s):

Mohamed Elmahdy ◽

Suzan Elsharkawy

Keyword(s):

Randomized Controlled Trial ◽

Gnrh Agonist ◽

Ovarian Stimulation ◽

Controlled Trial ◽

Chorionic Gonadotrophin ◽

Human Chorionic Gonadotrophin ◽

Randomized Controlled ◽

Gnrh Agonist Trigger ◽

Agonist Trigger ◽

Hcg Trigger

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Spontaneous clinical pregnancy following GNRH agonist trigger for final oocyte maturation and freeze-all approach: a case report

Reproductive BioMedicine Online ◽

10.1016/j.rbmo.2015.11.004 ◽

2016 ◽

Vol 32 (2) ◽

pp. 233-236 ◽

Cited By ~ 3

Author(s):

Hakan Yarali ◽

Gürkan Bozdag ◽

Mehtap Polat ◽

Irem Yarali ◽

Peter Humaidan

Keyword(s):

Case Report ◽

Oocyte Maturation ◽

Gnrh Agonist ◽

Clinical Pregnancy ◽

Final Oocyte Maturation ◽

Gnrh Agonist Trigger ◽

Agonist Trigger

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Comparison of a ‘freeze-all’ strategy including GnRH agonist trigger versus a ‘fresh transfer’ strategy including hCG trigger in assisted reproductive technology (ART): a study protocol for a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2017-016106 ◽

2017 ◽

Vol 7 (7) ◽

pp. e016106 ◽

Cited By ~ 5

Author(s):

Sacha Stormlund ◽

Kristine Løssl ◽

Anne Zedeler ◽

Jeanette Bogstad ◽

Lisbeth Prætorius ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Assisted Reproductive Technology ◽

Gnrh Agonist ◽

Controlled Trial ◽

Reproductive Technology ◽

Gnrh Agonist Trigger ◽

Randomised Controlled ◽

Agonist Trigger ◽

Hcg Trigger ◽

Fresh Transfer

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Improved clinical outcomes and lower OHSS risk with GnRH agonist trigger and hCG incorporated luteal support, compared to hCG trigger in GnRH-antagonist protocol for anticipated high responders

Fertility and Sterility ◽

10.1016/j.fertnstert.2013.07.243 ◽

2013 ◽

Vol 100 (3) ◽

pp. S517

Author(s):

A.K. Datta ◽

A. Eapen ◽

A. Kurinchi-Selvan ◽

G. Lockwood

Keyword(s):

Clinical Outcomes ◽

Gnrh Agonist ◽

Gnrh Antagonist ◽

Luteal Support ◽

Gnrh Agonist Trigger ◽

Gnrh Antagonist Protocol ◽

High Responders ◽

Agonist Trigger ◽

Antagonist Protocol ◽

Hcg Trigger

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Comparison of hCG Versus Gonadotropin-Releasing Hormone Agonist to Induce Oocyte Maturation in Assisted Reproductive Technology Cycles: A Retrospective Study

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2020.1034 ◽

2020 ◽

pp. 1

Author(s):

Gulay Beydilli Nacak ◽

Elif Tozkır ◽

Enis Ozkaya ◽

Ebru Cogendez ◽

Fatih Kaya

Keyword(s):

Gnrh Agonist ◽

Polycystic Ovarian Syndrome ◽

Gnrh Antagonist ◽

Control Group ◽

Study Group ◽

Ovarian Morphology ◽

Gnrh Agonist Trigger ◽

Ovarian Syndrome ◽

Agonist Trigger ◽

Hcg Trigger

OBJECTIVE: To compare some cycle characteristics and outcomes using a protocol consisting of a GnRH agonist trigger or hCG trigger after cotreatment with GnRH antagonist.STUDY DESIGN: Thirty-three patients under 35 years of age with polycystic ovarian syndrome, polycystic ovarian morphology, or previous high response who underwent ovulation trigger by GnRH agonist trigger and 132 patients under 35 years of age with the polycystic ovarian syndrome, polycystic ovarian morphology, or previous high response who underwent ovulation trigger by hCG for IVF treatment. Patients were non-randomly assigned to an ovarian stimulation protocol consisting of either GnRH agonist trigger after cotreatment with GnRH antagonist (study group) or hCG trigger after antagonist protocol (control group).RESULTS: The positive pregnancy test was obtained in 70 women in the control group whereas in 13 cases in the study group (p=0.161). No case in the study group needed hospitalization whereas there were 15 cases in the control group who were required to be hospitalized due to ovarian hyperstimulation related symptoms (p=0.04).CONCLUSIONS: The use of a protocol consisting of a GnRH agonist trigger after GnRH antagonist cotreatment and freeze-all strategy reduces the risk of ovarian hyperstimulation syndrome in high-risk patients undergoing IVF without affecting pregnancy rates.

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