Use of gonadotropin releasing hormone agonist trigger during in vitro fertilization is associated with similar endocrine profiles and oocyte measures in women with and without polycystic ovary syndrome

Capsule:
Use of a gonadotropin-releasing hormone agonist trigger during in vitro fertilization results in similar hormone profiles, mature oocyte yield, and pregnancy outcomes in women with polycystic ovarian syndrome when compared with other high responders.

Authors:
Kathleen E. O’Neill, M.D., Suneeta Senapati, M.D., M.S.C.E., Anuja Dokras, M.D., Ph.D.

Volume 103, Issue 1, Pages 264-269

Abstract:

Objective:
To compare endocrine profiles and IVF outcomes after using GnRH agonists (GnRHa) to trigger final oocyte maturation in women with polycystic ovary syndrome (PCOS) with other hyper-responders.

Design:
Retrospective cohort study.

Setting:
Academic center.

Patient(s):
Forty women with PCOS and 74 hyper-responders without PCOS.

Intervention(s):
GnRHa trigger.

Main Outcome Measure(s):
Number of oocytes.

Result(s):
Serum E2, LH, and P levels on the day of GnRHa trigger and the day after trigger did not differ significantly between groups. There were no significant differences in total number of oocytes or percent mature oocytes obtained between groups after controlling for age, antral follicle count, and total days of stimulation. The overall rate of no retrieval of oocytes after trigger was low (2.6%). Fertilization, implantation, clinical pregnancy, and live-birth rates were similar in the two groups. No patients developed ovarian hyperstimulation syndrome (OHSS).

Conclusion(s):
The similar post-GnRHa trigger hormone profiles and mature oocyte yield support the routine use of GnRHa trigger to prevent OHSS in women with PCOS.

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