Maternal and neonatal outcomes after gonadotropin releasing hormone agonist trigger for final oocyte maturation in patients undergoing in vitro fertilization

Capsule:
Gonadotropin-releasing hormone agonist trigger does not affect obstetrical or neonatal outcomes in antagonist cycles.

Authors:
Tara H. Budinetz, D.O., Jessica S. Mann, M.D., Daniel W. Griffin, M.D., Claudio A. Benadiva, M.D., John C. Nulsen, M.D., Lawrence L. Engmann, M.D.

Volume 102, Issue 3, Pages 753-758

Abstract:

Objective:
To compare the rate of congenital anomalies, obstetrical complications, and neonatal complications in antagonist cycles where either GnRH agonist (GnRHa) or hCG was used for final oocyte maturation.

Design:
Retrospective cohort study.

Setting:
University-based tertiary fertility center.

Patient(s):
Three hundred ninety-two women under 40 years of age who underwent controlled ovarian stimulation using a GnRH antagonist protocol and who had final oocyte maturation triggered with either a GnRHa or hCG that resulted in pregnancy and delivery after 16 weeks’ gestation.

Intervention(s):
GnRHa versus hCG trigger of final oocyte maturation.

Main Outcome Measure(s):
Congenital anomaly rates, obstetrical complications, and neonatal complications.

Result(s):
There were no significant differences in the rate of congenital anomalies between GnRHa and hCG trigger (6.6 vs. 9.2%). There were also no differences in the maternal complications (27.6 vs. 20.8%) or neonatal complications (19.7 vs. 20.0%) between the GnRHa trigger and hCG trigger groups.

Conclusion(s):
GnRHa trigger does not affect the rate of congenital anomalies or obstetrical or neonatal complications and remains a viable option in the prevention of ovarian hyperstimulation syndrome.

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