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| Name | Class |
|---|---|
| National Natural Science Foundation of China | OTHER_GOV |
| Comprehensive Strategic Cooperation Project of Guangdong Province and Chinese Academy of Science | OTHER |
| Guangzhou Science and Technology Program key projects |
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Gonadotropin releasing hormone (GnRH) agonist is sufficient for triggering final oocyte maturation in GnRH antagonist protocol and can significantly reduce incidence of ovarian hyperstimulation syndrome (OHSS) in high-risk patients.
However, lower oocyte yield was reported in patients with lower luteinizing hormone (LH) level post trigger with single injection of GnRH agonist, which might be related to the shorter duration and lower amount of LH induced by GnRH agonist.
Our aim is to study repeated injection of GnRH agonist for preventing OHSS and maintaining clinical outcome in high risk patients who receive controlled ovarian stimulation in GnRH antagonist protocol.
This was a prospective cohort study of all women attending the Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Nanfang Hospital, affiliated with Southern Medical University for in vitro fertilization and/or intracytoplasmic sperm injection . Women at high risk of OHSS who received IVF and/or intracytoplasmic sperm injection (ICSI) treatment with a flexible GnRH antagonist protocol were recruited to participate in this study.
All patients underwent standard ovarian stimulation protocol with gonadotropins, standard individualized adjustment of medication dose, and standard egg retrieval procedure. Patients were triggered with a single bolus of 0.2 mg triptorelin at night and had second injection of 0.2 mg triptorelin 12 hours later when the criteria for administration of the ovulation trigger were met.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Repeated GnRHa | Experimental | Patients were triggered with repeated GnRHa |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| triptorelin | Drug | 0.2 mg, ih, at night and 0.2 mg, ih, 12 hours later when at least one of the following criteria was reached: (i) serum E2 ≥3500 pg/ml, (ii) ≥18 follicles measuring ≥11 mm. |
| Measure | Description | Time Frame |
|---|---|---|
| clinical pregnancy rate per transfer cycle | 1month post embryo transfer | |
| numbers of patients having OHSS | 2 weeks post trigger with repeated GnRHa | |
| oocyte yield | Oocyte yield was defined as the ratio of the total number of collected oocytes to the number of follicles measuring ≥10 mm on the day of oocyte retrieval. | oocyte retrieval day (34 to 38 hours post the first trigger with GnRHa) |
| Oocyte maturity | Oocyte maturity was defined as the ratio of metaphase II (MII) oocytes to the number of collected oocytes in the patients undergoing with ICSI. | 24 hours post oocyte retrieval day |
| Measure | Description | Time Frame |
|---|---|---|
| serum luteinizing hormone level 12 hours post first trigger | 12 hours post trigger with the first injection of GnRHa | |
| serum luteinizing hormone level 24 hours post first trigger | 24 hours post the first injection of GnRHa |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Shi-Ling Chen, M.D., Ph.D. | Contact | +86-20-62787604 | chensl_92@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Shi-Ling Chen, M.D., Ph.D. | Nanfang Hospital, Southern Medical University | Study Chair |
| Xin Chen, M.D., Ph.D. | Nanfang Hospital, Southern Medical University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Nanfang Hospital, Southern Medical University | Recruiting | Guangzhou | Guangdong | 510515 | China |
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| ID | Term |
|---|---|
| D007246 | Infertility |
| D016471 | Ovarian Hyperstimulation Syndrome |
| D011085 | Polycystic Ovary Syndrome |
| ID | Term |
|---|---|
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D010049 | Ovarian Diseases |
| D000291 | Adnexal Diseases |
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| ID | Term |
|---|---|
| D017329 | Triptorelin Pamoate |
| ID | Term |
|---|---|
| D007987 | Gonadotropin-Releasing Hormone |
| D010906 | Pituitary Hormone-Releasing Hormones |
| D007028 | Hypothalamic Hormones |
| D036361 | Peptide Hormones |
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| National Key Basic Research Development Plan of China | UNKNOWN |
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| fertilization rate | Fertilization rate was defined as the ratio of normal fertilized oocytes (2PNs) to the number of oocytes used for fertilization (i.e. the denominator in IVF in calculating fertilization rate is all oocytes recovered, but in ICSI it is calculated using only the number of MII oocytes). | 48 hours post IVF/ICSI |
| implantation rate | 1 month post embryo transfer |
| D005831 |
| Genital Diseases, Female |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D006058 | Gonadal Disorders |
| D004700 | Endocrine System Diseases |
| D010048 | Ovarian Cysts |
| D003560 | Cysts |
| D009369 | Neoplasms |
| D006728 | Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
| D009479 | Neuropeptides |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D009842 | Oligopeptides |
| D009419 | Nerve Tissue Proteins |
| D011506 | Proteins |