Clinical efficacy of dual trigger with human chorionic gonadotropin and a gonadotropin-releasing hormone agonist for women undergoing fertility preservation

Reproductive medicine and biology

article

Yeon Hee Hong¹  Seul Ki Kim¹  Jung Ryeol Lee¹  Byung Chul Jee¹  Chang Suk Suh² 

[1] Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital;Department of Obstetrics and Gynecology, Seoul National University College of Medicine;Department of Surgical Oncology, Sheikh Khalifa Specialty Hospital

关键词: dual trigger;    fertility preservation;    gonadotropin-releasing hormone agonist;    human chorionic gonadotropin;    mature oocytes;   

DOI  :  10.1002/rmb2.12440

学科分类：工业工程学

来源: Wiley

【 摘 要 】

Purpose To determine the optimal maturation method to increase the yield of mature oocytes, especially for cancer patients with fewer chances of fertility preservation (FP) before gonadotoxic therapy. Methods A total of 373 cycles in 293 patients undergoing controlled ovarian stimulation (COS) for FP using a gonadotropin-releasing hormone (GnRH) antagonist protocol were enrolled. The control group ( n =  225) received 250 µg of recombinant human chorionic gonadotropin (rhCG) while the study group ( n =  148) received 250 µg of rhCG and 0.2 mg of triptorelin for triggering. Subgroup analyses were performed for stimulation cycles with diminished ovarian reserve (DOR; anti-Müllerian hormone (AMH) levels <1.1 ng/ml, n =  86), with endometrioma ( n =  104), or with breast cancer and endometrial cancer using 5 mg of letrozole during the COS cycles ( n =  84). Results There was no significant difference in the baseline characteristics or the number of total and mature oocytes between the two groups. Subgroup analyses for women with endometrioma or DOR showed similar results. However, the dual trigger group had a significantly higher number of mature oocytes than the rhCG trigger group in breast and endometrial cancer patients using letrozole during the COS cycles (6.9 ± 6.0 vs. 4.6 ± 3.6, p  = 0.034). The maturation rate was higher in the dual trigger group, although the difference was not statistically significant (59.3 ± 26.7 vs. 50.0 ± 28.0, p  = 0.124). Conclusions Dual triggering can be an efficient maturation method to maximize the yield of mature oocytes in breast or endometrial cancer patients using letrozole-combined GnRH antagonist protocol for FP.

【 授权许可】

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