Gonadotropin releasing hormone agonist trigger in oocyte donors co treated with a gonadotropin releasing hormone antagonist A dose finding study

Capsule:
Comparable numbers of mature oocytes and top quality embryos are retrieved after the use of triptorelin doses of 0.2, 0.3, or 0.4 mg to trigger ovulation in oocyte donors.

Capsule:
Comparable numbers of mature oocytes and topquality embryos are retrieved after the use of triptorelin doses of 0.2, 0.3, or 0.4 mg to trigger ovulation in oocyte donors.

Authors:
Vuong Thi Ngoc Lan, M.D., Ho Manh Tuong, M.D., Ha Tan Duc, M.D., Phung Huy Tuan, M.D., Huynh Gia Bao, M.D., Peter Humaidan, D.M.Sc.

Volume 105, Issue 2, Pages 356-363

Abstract:

Objective:
To determine the optimal GnRH agonist dose for triggering of oocyte maturation in oocyte donors.

Design:
Single-center, randomized, parallel, investigator-blinded trial.

Setting:
IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam.

Patient(s):
One hundred sixty-five oocyte donors (aged 18–35 years, body mass index [BMI] <28 kg/m2, antimüllerian hormone level >1.25 ng/mL, and antral follicle count ≥6).

Intervention(s):
Ovulation trigger with 0.2, 0.3, or 0.4 mg triptorelin in a GnRH antagonist cycle.

Main Outcome Measure(s):
The primary end point was number of metaphase II oocytes. Secondary end points were fertilization and cleavage rates, number of embryos and top-quality embryos, steroid levels, ovarian volume, and ongoing pregnancy rate (PR) in recipients.

Result(s):
There were no significant differences between the triptorelin 0.2, 0.3, and 0.4 mg trigger groups with respect to number of metaphase II (16.0 ± 8.5, 15.9 ± 7.8, and 14.7 ± 8.4, respectively), embryos (13.2 ± 7.8, 11.7 ± 6.9, 11.8 ± 7.0), and number of top-quality embryos (3.8 ± 2.9, 3.6 ± 3.0, 4.1 ± 3.0). Luteinizing hormone levels at 24 hours and 36 hours after trigger was significantly higher with triptorelin 0.4 mg versus 0.2 mg and 0.3 mg (9.8 ± 7.1 IU/L vs. 7.3 ± 4.1 IU/L and 7.2 ± 3.7 IU/L, respectively; 4.6 ± 3.2 IU/L vs. 3.2 ± 2.3 IU/L and 3.3 ± 2.1 IU/L, respectively. Progesterone level at oocyte pick-up +6 days was significantly higher in the 0.4-mg group (2.2 ± 3.7 IU/L) versus 0.2 mg (1.1 ± 1.0 IU/L) and 0.3 mg (1.2 ± 1.6 IU/L). One patient developed early-onset severe ovarian hyperstimulation syndrome (OHSS).

Conclusion(s):
No significant differences between triptorelin doses of 0.2, 0.3, and 0.4 mg used for ovulation trigger in oocyte donors were seen with regard to the number of mature oocytes and top-quality embryos.

Clinical Trial Registration Number:
NCT02208986.

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