Efficiency of GnRH agonist trigger on embryo cultural outcomes in IVF subjects with diminished ovarian reserve

doi:10.12092/j.issn.1009-2501.2019.07.012

Abstract

Abstract:

AIM: To compare the effect of two trigger protocols-GnRH agonist and hCG on in vitro fertilization cultural outcome in patients with diminished ovarian reserve (DOR). METHODS: The patients with DOR undertaking the first cycle of IVF treatment in our IVF center were recruited for this study, and those with GnRH antagonist down-regulation stimulation excluded. All subjects were analyzed in two groups-GnRHa and hCG. The outcomes of oocyte retrieval, normal fertilization, embryo development were compared between the two groups. RESULTS:Comparison of GnRHa and hCG between the two groups showed no significant difference in age, BMI, index of basal function of ovary and the related parameters of treatment. In group GnRHa, the normal fertilization rate (% egg number), available embryo rate (% egg number), good embryo rate (% egg number) and good embryo per embryo were 73.03%, 63.10% and 42.24% respectively, which were significantly higher than those of the hCG. However, the aforementioned significance did not existed after applying the model of generalized estimation equation for the balancing age, ovarian reserve function, infertility factors and treatment regimen. CONCLUSION:GnRHa trigger may result in an equal laboratory culture outcomes to hCG, which need to be further confirmed by prospective studies.

Key words: trigger protocol, GnRHa, hCG, cultural outcome, in vitro fertilization

CLC Number:

R711.75
R321

ZHANG Ling, XU Weihai, HUANG Qiongxiao, FU Xiaohua, ZHANG Lin, LI Shishi, ZHU Jing, WU Ruifang, SHU Jing. Efficiency of GnRH agonist trigger on embryo cultural outcomes in IVF subjects with diminished ovarian reserve[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2019, 24(7): 799-804.

References

［1］Dosouto C, Haahr T, Humaidan P. Gonadotropin-releasing hormone agonist (GnRHa) trigger-State of the art［J］. Reprod Biol, 2017,17(1): 1-8.
［2］张雨, 刘雨生, 张娱, 等. 不同扳机方案在卵巢储备功能减退患者中的应用［J］. 安徽医科大学学报, 2017,9(52)：1323-1326.
［3］刘宝莲, 宁艳春, 樊桂玲, 等. HCG和GnRH－a在微刺激方案IVF中扳机作用效果分析［J］. 河北医药, 2015,37(23): 3619-3620.
［4］Cohen J, Chabbert-Buffet N, Darai E. Diminished ovarian reserve, premature ovarian failure, poor ovarian responder-a plea for universal definitions［J］. J Assist Reprod Genet, 2015,32(12): 1709-1712.
［5］Williamson JM, Datta S, Satten GA. Marginal analyses of clustered data when cluster size is informative［J］. Biometrics, 2003,59(1): 36-42.
［6］魏占才, 高明霞, 张学红. hCG对卵泡及子宫内膜发育作用的研究进展［J］. 生殖与避孕, 2016,36(9): 758-762.
［7］杨媛, 胡俊平. IVF/ICSI周期中拮抗剂方案扳机方式的选择［J］. 国际生殖健康/计划生育杂志, 2017,36(4): 327-330.
［8］Humaidan P, Kol S, Papanikolaou EG, et al. GnRH agonist for triggering of final oocyte maturation: time for a change of practice［J］ ? Hum Reprod Update, 2011,17(4): 510-524.
［9］Sahin S, Ozay A, Ergin E, et al. The risk of ectopic pregnancy following GnRH agonist triggering compared with hCG triggering in GnRH antagonist IVF cycles［J］. Arch Gynecol Obstet, 2015,291(1): 185-191.
［10］Humaidan P, Bredkjaer HE, Bungum L, et al. GnRH agonist (buserelin) or hCG for ovulation induction in GnRH antagonist IVF/ICSI cycles: a prospective randomized study［J］. Hum Reprod, 2005,20(5): 1213-1220.
［11］Erb TM, Vitek W, Wakim AN. Gonadotropin-releasing hormone agonist or human chorionic gonadotropin for final oocyte maturation in an oocyte donor program［J］. Fertil Steril, 2010,93(2): 374-378.
［12］Humaidan P, Ejdrup Bredkjar H, Westergaard LG, et al. 1,500 IU human chorionic gonadotropin administered at oocyte retrieval rescues the luteal phase when gonadotropin-releasing hormone agonist is used for ovulation induction: a prospective, randomized, controlled study［J］. Fertil Steril, 2010,93(3): 847-854.
［13］Datta AK, Eapen A, Birch H, et al. Retrospective comparison of GnRH agonist trigger with HCG trigger in GnRH antagonist cycles in anticipated high-responders［J］. Reprod Biomed Online, 2014,29(5): 552-558.
［14］Tannus S, Turki R, Cohen Y, et al. Reproductive outcomes after a single dose of gonadotropin-releasing hormone agonist compared with human chorionic gonadotropin for the induction of final oocyte maturation in hyper-responder women aged 35-40 years［J］. Fertil Steril, 2017,107(6): 1323-1328,1322.
［15］Chiu YH, Karmon AE, Gaskins AJ, et al. Serum omega-3 fatty acids and treatment outcomes among women undergoing assisted reproduction［J］. Human reproduction (Oxford, England), 2018,33(1): 156-165.
［16］Farquhar CM, Bhattacharya S, Repping S, et al. Female subfertility［J］. Nat Rev Dis Primers, 2019,5(1): 7.

[1]	ZHAO Quanfeng, FU Peishu, GU Wenrui, ZHEN Dan, LV Zongjie, YANG Yang. Advances in evidence-based medical research of GnRHa for fertility protection after chemotherapy [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2021, 26(12): 1449-1454.
[2]	HU Weihua, YAN Yongxu, RUAN Jian, HOU Wenwen. Effects of subclinical hypothyroidism on the outcome of in vitro fertilization and embryo transfer [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2018, 23(5): 552-556.
[3]	YANG Hai-yan, ZHAO Jun-zhao, LIN Wen-qin, LIN Jin-ju, RU Rong. Comparison of prednisone versus hydroxyethylstarch for prevention of moderate and severe ovarian hyperstimulation syndrome [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2011, 16(6): 652-656.