Volume 15, Issue 7 (8-2017)                   IJRM 2017, 15(7): 429-434 | Back to browse issues page


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Eftekhar M, Farid Mojtahedi M, Miraj S, Omid M. Final follicular maturation by administration of GnRH agonist plus HCG versus HCG in normal responders in ART cycles: An RCT. IJRM. 2017; 15 (7) :429-434
URL: http://journals.ssu.ac.ir/ijrmnew/article-1-837-en.html
1- Reasearch and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran, Iran
2- Department of Obstetrics and Gynecology, Endocrinology and Female Infertility Unit, Roointan Arash Women’s Health Research and Educational Hospital, Tehran University of Medical Sciences, Tehran, Iran, Iran , m_fmojtahedi@ssu.ac.ir
3- Department of Obstetrics and Gynecology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran, Iran
Abstract:   (284 Views)
Background: Gonadotropin-releasing hormone agonists (GnRH-a) was increasingly used for triggering oocyte maturationfor the prevention of ovarian hyperstimulation syndrome. Studies suggest that GnRH-a might be used as a better trigger agent since it causes both Luteinizing hormone and follicle stimulating hormone release from a physiologic natural cycle.
Objective: The aim of this study was to evaluate the effect of dual-triggering in assisted reproductive technology outcomes.
Materials and Methods: 192 normal responder women aged ≤42 years and 18< Body Mass Index <30 kg/m2 enrolled in this single-blind randomized controlled trial. All participants received antagonist protocol. For final triggering, women randomly were divided into two groups. Group, I was triggered by 6500 IU human chorionic gonadotropin (hCG) alone, and group II by 6500 IU hCG plus 0.2 mg of triptorelin. The implantation, chemical, clinical and ongoing pregnancy, and abortion rates were measured.
Results: The mean of retrieved oocytes and obtained embryos were statistically higher in the dual-trigger group (group I), but the implantation and pregnancy rates were similar in two groups.
Conclusion: The results of our study did not confirm the favorable effect of dual-triggered oocyte maturation with a GnRH-a and a standard dosage of hCG as an effective strategy to optimize pregnancy outcome for normal responders in GnRH-antagonist cycles. We think that this new concept requires more studies before becoming a universal controlled ovarian hyperstimulation protocol in in vitro fertilization practice.
Full-Text [PDF 401 kb]   (122 Downloads) |   |   Full-Text (HTML)  (25 Views)  
Type of Study: Original Article |
Received: 2017/10/1 | Accepted: 2017/10/14 | Published: 2017/10/14

References
1. Fauser BC, de Jong D, Olivennes F, Wramsby H, Tay C, Itskovitz-Eldor J, et al. Endocrine profiles after triggering of final oocyte maturation with GnRH agonist after cotreatment with the GnRH antagonist ganirelix during ovarian hyperstimulation for in vitro fertilization. J Clin Endocrinol Metab 2002; 87: 709-715. [DOI:10.1210/jcem.87.2.8197]
2. Eftekhar M, MirajS, MortazavifarZ. The effect of luteal phase gonadotropin-releasing hormone antagonist administration on IVF outcomes in women at risk of OHSS. Int J Reprod BioMed 2016; 14: 507.
3. Gonen Y, Balakier H, Powell W, Casper RF. Use of Gonadotropin-Releasing Hormone Agonist to Trigger Follicular Maturation for in Vitro Fertilization. J Clin Endocrinol Metab 1990; 71: 918-922. [DOI:10.1210/jcem-71-4-918]
4. Casarini L, Lispi M, Longobardi S, Milosa F, La Marca A, Tagliasacchi D, et al. LH and hCG action on the same receptor results in quantitatively and qualitatively different intracellular signaling. PLoS One 2012; 7: e46682. [DOI:10.1371/journal.pone.0046682]
5. Haas J, Ophir L, Barzilay E, Yerushalmi GM, Yung Y, Kedem A, et al. GnRH agonist vs hCG for triggering of ovulation-differential effects on gene expression in human granulosa cells. PloS One 2014: 9; e90359. [DOI:10.1371/journal.pone.0090359]
6. Haas J, Zilberberg E, Dar Sh, Kedem A,Machtinger R, Orvieto R, et al. Co-administration of GnRH-agonist and hCG for final oocyte maturation (double trigger) in patients with low number of oocytes retrieved per number of preovulatory follicles-a preliminary report. J Ovarian Res 2014; 7:77. [DOI:10.1186/1757-2215-7-77]
7. Lin MH, Wu FS, Lee RK, Li SH, Lin SY, Hwu YM. Dual trigger with combination of gonadotropin-releasing hormone agonist and human chorionic gonadotropin significantly improves the live-birth rate for normal responders in GnRH-antagonist cycles. Fertil Steril 2013; 100: 1296-1302. [DOI:10.1016/j.fertnstert.2013.07.1976]
8. Schachter M, Friedler S, Ron-El R, Zimmerman AL, Strassburger D, Bern O, et al. Can pregnancy rate be improved in gonadotropin-releasing hormone (GnRH) antagonist cycles by administering GnRH agonist before oocyte retrieval? A prospective, randomized study. Fertil Steril 2008; 90: 1087-1093. [DOI:10.1016/j.fertnstert.2007.07.1316]
9. Shapiro BS, Daneshmand ST, Garner FC, Aguirre M, Hudson C.Comparison of "triggers" using leuprolide acetate alone or in combination with low-dose human chorionic gonadotropin. Fertil Steril 2011; 95: 2715-2717. [DOI:10.1016/j.fertnstert.2011.03.109]
10. Rosini R, Campisi E, De Chiara M, Tettelin H, Rinaudo D, Toniolo C, et al. Genomic analysis reveals the molecular basis for capsule loss in the group B Streptococcus population. PLoS One 2015. 10: e0125985. [DOI:10.1371/journal.pone.0125985]
11. Kilpi TM, Silfverdal SA, Nilsson L, Syrjänen R, Belloni C, Desole M, et al. Immunogenicity and reactogenicity of two diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated polio virus-Haemophilus influenzae type b vaccines administered at 3, 5 and 11-12 months of age. Hum Vaccin 2009; 5: 18-25. [DOI:10.4161/hv.5.1.6369]
12. Griffin D, Feinn R, Engmann L, Nulsen J, Budinetz T, Benadiva C. Dual trigger with gonadotropin-releasing hormone agonist and standard dose human chorionic gonadotropin to improve oocyte maturity rates. Fertil Steril 2014; 102: 405-409. [DOI:10.1016/j.fertnstert.2014.04.028]
13. Decleer W, OsmanagaogluK, SeynhaveB, KolibianakisS, TarlatzisB, DevroeyP. Comparison of hCG triggering versus hCG in combination with a GnRH agonist: a prospective randomized controlled trial. Facts Views Vis Obstet Gynecol 2014; 6: 203-209.
14. Casa- EM, Raga F, Bonilla-Musoles F, Polan ML. Human Oviductal Gonadotropin-Releasing Hormone: Possible Implications in Fertilization, Early Embryonic Development, and Implantation 1. J Clin Endocrinol Metab 2000; 85: 1377-1381.
15. Eftekhar M, Dehghani Firouzabadi R, Karimi H, Rahmani E. Outcome of cryopreserved-thawed embryo transfer in the GnRH agonist versus antagonist protocol. Iran J Reprod Med 2012; 10: 297-302.
16. Kol S. Embryo implantation and GnRH antagonists GnRH antagonists in ART: lower embryo implantation? Hum Reprod 2000; 15: 1881-1882. [DOI:10.1093/humrep/15.9.1881]
17. Liu J, Cao B, Li YX, Wu XQ, Wang YL. GnRH I and II up-regulate MMP-26 expression through the JNK pathway in human cytotrophoblasts. Reprod Biol Endocrinol 2010; 8: 1. [DOI:10.1186/1477-7827-8-5]
18. Sasaki K, Norwitz ER. Gonadotropin-releasing hormone/gonadotropin-releasing hormone receptor signaling in the placenta. Curr Opin Endocrinol Diabetes Obes 2011; 18: 401-408. [DOI:10.1097/MED.0b013e32834cd3b0]
19. Rackow BW, Kliman HJ, Taylor HS. GnRH antagonists may affect endometrial receptivity. Fertil Steril 2008; 89: 1234-1239. [DOI:10.1016/j.fertnstert.2007.04.060]
20. Orvieto R. Triggering final follicular maturation-hCG, GnRH-agonist or both, when and to whom? J Assist Reprod Genet 2016; 33: 1415-1416. [DOI:10.1007/s10815-016-0775-4]

Add your comments about this article : Your username or Email:
CAPTCHA code

Send email to the article author


© 2018 All Rights Reserved | International Journal of Reproductive BioMedicine

Designed & Developed by : Yektaweb