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.

Field experiences with early pregnancy diagnosis by progesterone-based ELISA in sows

In four Kenyan pig breeding units the pregnancy diagnosis of sows has been carried out in two groups: Group 1 (n = 1911): the sows were transrectaly pregnancy tested between Days 17–22 post-mating by ultrasound. Sows testing non-pregnant immediately received one dose of 400 IU pregnant mare serum gonadotropin (PMSG) (equine chorion gonadotropin, eCG) and 200 IU human chorion gonadotropin (hCG). On showing signs of oestrous, the animals were subsequently artificially inseminated (AI). Group 2 (n = 1923): sows were pregnancy tested by serum progesterone (P4)-based enzyme-linked immunosorbent assay (ELISA) on Day 17 post-breeding. P4 concentrations were categorized as positive (> 5 ng/ml) or negative (< 5 ng/ml). Sows testing non-pregnant immediately received one dose of 400 IU PMSG and 200 IU hCG by injection, and were subsequently artificially inseminated. The following parameters were evaluated: sows diagnosed non-pregnant, days from first post-weaning insemination until the sows were inseminated at their first return to oestrus; farrowing rate and total piglets born and number of live-born piglets in litters.The percentage of sows diagnosed non-pregnant in the two groups, as well as the totals of born piglets and of live-born piglets in litters did not differ significantly between the two groups. The number of days from the first post-weaning mating until the sows were artificially inseminated at their first return to oestrus and the administration of eCG and hCG was shorter (P < 0.01) and farrowing rate was higher (P < 0.01) in the ELISA-tested sows.

Reproductive traits in primiparous sows in relation to feeding level.

To estimate the effect of plane of nutrition and induction of oestrus with 400 IU of pregnant mare serum and 200 IU of human chorion gonadotropin, 113 primiparous Dutch Landrace sows were given 4 or 2.5 kg feed daily from weaning to oestrus. The feed included maize 12, barley 18, soya bean oilmeal 15, wheat bran 15, cassava pellets 13, maize gluten feed 5, lucerne meal 8, citrus pulp 5.5, molasses 5, animal protein 1.1%, minerals and vitamins. The number of sows in oestrus within 21 days of weaning was 69 (61%). Within 7 days of induction of oestrus on day 21, 41 sows were in oestrus (36%). On day 21, 37 (65%) of the better-fed sows were in oestrus and 32 (53%) of the poorer-fed group. The interval from weaning to spontaneous oestrus was 9.1 and 8.2 days, respectively, and ovulation rate 15.2 and 14.8. Size of the sexual organs was not affected by feeding level. Rate of gain of sows during the interval from weaning to oestrus was influenced by feeding level: +4.1 kg and -2.3 kg, respectively, for the sows in oestrus within 21 days of weaning. Sows with induced oestrus shed significantly more ova than did sows in which oestrus was not induced (21.7 and 15.0, respectively). Loss of weight, loss of heart girth, and loss of backfat thickness during previous lactation (absolute and relative) did not differ for sows with or without induction, but was higher for sows with a spontaneous oestrus between 10 and 21 days after weaning than for sows with an oestrus within 10 days after weaning. Ovulation rate was not affected by weight at weaning or at oestrus, weight loss during lactation, gain during the interval from weaning to oestrus or size of the preceeding litter at birth. (Abstract retrieved from CAB Abstracts by CABI’s permission)