Reflections on “Antimüllerian hormone in GnRH antagonist cycles: Prediction of ovarian response and cumulative treatment outcome in good-prognosis patients” by Arce et al.
Assessment of current strengths and limitations of antimullerian hormone and antral follicle count as ovarian biomarkers for assisted reproduction and evaluation of their future clinical applications by other health-care providers.
Dual trigger with GnRH agonist and low-dose hCG in high responders with peak E2 levels <4,000 pg/mL improves live birth rates.
Dopamine agonists, decreased FSH and hCG doses, coasting, agonist trigger, paracentesis, metformin, low-dose aspirin, anticoagulation, and possibly FSH co-trigger are measures that prevent or reduce the severity of OHSS.
FSH co-trigger after ovarian stimulation has been shown to improve oocyte competence and a recent report suggested that the FSH co-trigger can completely prevent OHSS.
Intensive luteal phase support is effective in improving pregnancy rates after GnRHa trigger.
Low-dose hCG supplementation after GnRHa trigger secures the reproductive outcome and minimizes the risk of OHSS in the high-risk IVF patient.
Agonist triggering combined with oocyte vitrification and ET in a subsequent natural cycle avoids ovarian hyperstimulation syndrome in patients at risk and shows excellent cycle outcome.
GnRH antagonist cycles are associated with a lower risk of OHSS and should be the protocol of choice in high-risk patients; and coasting is a useful protocol for prevention of OHSS.
A review of the role played by VEGF on OHSS etiologyand the protective effect of dopamine agonists.
Fertility & Sterility Discussion Forums