Gonadotropin levels at the start of ovarian stimulation predict normal fertilization after hCG re-trigger in GnRH antagonist cycles

Reproductive medicine and biology

article

Hiroya Kitasaka¹  Mikiko Tokoro¹  Masae Kojima¹  Noritaka Fukunaga¹  Yoshimasa Asada¹ 

[1] Asada Ladies Clinic;Asada Institute for Reproductive Medicine

关键词: controlled ovarian stimulation;    gonadotropin-releasing hormone antagonist protocol;    gonadotropin-releasing hormone agonist trigger;    luteinizing hormone surge;    oocyte maturation;   

DOI  :  10.1002/rmb2.12359

学科分类：工业工程学

来源: Wiley

【 摘 要 】

Purpose To assess the appropriateness of human chorionic gonadotropin (hCG) re-trigger in poor responders to gonadotropin-releasing hormone agonist (GnRHa) trigger in controlled ovarian stimulation (COS) cycles. Methods The 2251 cycles in 2251 patients triggered with GnRHa for oocyte stimulation, with or without requiring hCG re-trigger between 2013 and 2018, were retrospectively analyzed to compare gonadotropin levels at the start of COS and the rate of normal fertilization between the re-trigger and non–re-trigger group. Furthermore, patients in the re-trigger group were stratified by the rate of normal fertilization (good: ≥60% or poor: <60%) to compare patient demographics, hormone profiles, and clinical outcome between the subgroups. Results In the re-trigger group, FSH and LH levels at the start of COS were significantly lower in the good fertilization group than in the poor fertilization group ( P  < .01). Receiver operating characteristic curves identified cutoff values of the FSH and LH levels of 1.30 and 0.35 mIU/mL, respectively, for predicting ≥60% normal fertilization. Conclusion Gonadotropin levels at the start of COS are predictors of response to GnRHa trigger and hCG re-trigger necessity, and may serve as indicators to help clinicians appropriately choose hCG re-trigger rather than abandoning the cycles or continuing the first oocyte aspiration attempt.

【 授权许可】

CC BY|CC BY-NC|CC BY-NC-ND