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Introduction OHSS still remains a complication of assisted reproduction treatments. hCG administration to trigger final oocyte maturation will release vascular mediators, being VEGF and other proteins such as VE-Cadherin or Angiopoietin- 2. It has been shown that replacing hCG by GnRH agonists will induce a very short endogenous LH peak, potent enough to induce final oocyte maturation but no OHSS will develop. The investigators examined VEGF, VE-Cadherin and Angiopoietin-2 modulation by hCG as well as GnRH agonists in oocyte donors undergoing controlled ovarian stimulation.
Material and Methods Between June and December of 2008 we evaluated 90 egg donors. They underwent COH with 150 IU rFSH as starting dose, we separated them in 3 groups (n:30 each): Groups 1 and 2 received a 0.25mg daily dose of GnRH antagonist when a follicle 14mm in diameter was observed. hCG 250g was given to group 1 while group 2 received triptorelin 0.2mg when leading two follicles were 17mm. Group 3 was stimulated with standard long protocol, hCG was given following similar criteria.
Blood was collected the day of hCG/aGnRH administration as well as the day of egg retrieval, and follicular fluid from the first two mature follicles was also frozen. We collected granulosa cells (GC) of 10 patients of each group as well Levels of VEGF, sVE-Cadherin an Angiopietin 2 were determined by ELISA in serum and in follicular fluid.
Results were analyzed via ANOVA.Data are expressed as mean± SEM. A significant difference was defined as p< 0.05.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Antagonist-hCG for triggering | Protocol with antagonist and hCG to trigger oocyte maturation | ||
| Antagonist-aGnRH for triggering | Protocol with antagonist and 0,2 mg triptorelin to trigger oocyte maturation | ||
| Long protocol-hCG for triggering | Long Protocol and hCG to trigger oocyte maturation |
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| Measure | Description | Time Frame |
|---|---|---|
| VEGF Protein and mRNA Levels | VEGF concentration in follicular fluid and VEGF mRNA expression in granulosa cells from patients who received either GnRH agonist instead of hCG | 1 year |
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Inclusion Criteria:
Exclusion Criteria:
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oocyte Donors
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| ID | Title | Description |
|---|---|---|
| FG000 | Antagonist Trigger With aGnRH | Protocol with antagonist and 0,2 mg triptorelin to trigger oocyte maturation |
| FG001 | Antagonist Trigger With hCG | Protocol with antagonist and hCG to trigger oocyte maturation |
| FG002 | Long Protocol hCG | Long Protocol with hCG to trigger oocyte maturation |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Antagonist-hCG to Trigger | Protocol with antagonist and hCG to trigger oocyte maturation |
| BG001 | Antagonist-aGnRH to Trigger | Protocol with antagonist and 0.2 mg triptorelin to trigger oocyte maturation |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | VEGF Protein and mRNA Levels | VEGF concentration in follicular fluid and VEGF mRNA expression in granulosa cells from patients who received either GnRH agonist instead of hCG | Posted | Mean | Standard Deviation | pg/ml | 1 year |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | GnRH Antagonist - hCG Trigger | GnRH antagonist protocol and hCG trigger |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dra Cerrillo | IVI Madrid | 911802900 | maria.cerrillo@ivi.es |
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follicular fluid
| BG002 | Long Protocol-hCG | Long Protocol and hCG to trigger oocyte maturation |
| BG003 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | The donors were recruit for the clinic | Number | participants |
|
Levels of VEGF in folicular fluid of patients with long protocol anf hCG for triggering |
|
|
|
| 0 |
| 32 |
| 0 |
| 32 |
| EG001 | GnRH Antagonist Triptorelin Trigger | GnRH antagonist protocol and triptorelin trigger | 0 | 32 | 0 | 32 |
| EG002 | Long Protocol - hCG Trigger | Long protocol and hCG trigger as control | 0 | 32 | 0 | 32 |
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