Intranasal gonadotropin-releasing hormone agonist (GnRHa) for luteal-phase support following GnRHa triggering, a novel approach to avoid ovarian hyperstimulation syndrome in high responders

We discuss how continuous administration of gonadotropin- releasing hormone (GnRH) agonist after GnRH agonist ovulation trigger succeeded in luteal-phase support in high-responder patients, with high ongoing pregnancy rate and no cases of ovarian hyperstimulation syndrome.

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Volume 106, Issue 2, Pages 330-334

Authors:

Itai Bar-Hava, M.D., Yossi Mizrachi, M.D., Daphne Karfunkel-Doron, M.Sc., Yeela Omer, B.A., Liron Sheena, M.D., Nurit Carmon, Bs.C.D.R., Gila Ben-David, M.D.

Abstract:

Objective

To study whether intranasal GnRH agonist (GnRHa) can be effectively used for luteal support in high-responder patients undergoing fresh-embryo transfer after ovulation induction with the use of GnRHa.

Design

Retrospective cohort study.

Setting

Private fertility clinic.

Patient(s)

Forty-six high-responder patients were administered a GnRHa ovulation trigger to avoid ovarian hyperstimulation syndrome (OHSS), followed by 2 weeks of daily intranasal GnRHa (nafarelin) for luteal-phase support. No additional progesterone supplementation was administrated.

Intervention(s)

Intranasal GnRHa for luteal-phase support.

Main Outcome Measure(s)

The primary outcome was ongoing clinical pregnancy rate.

Result(s)

High median progesterone levels were measured at midluteal phase and on the day of the first positive pregnancy test (190 nmol/L on both measures). We obtained 24 (52.1%) ongoing clinical pregnancies. None of the patients developed OHSS.

Conclusion(s)

Intranasal GnRHa is effective in achieving luteal-phase support in high-responder patients triggered with GnRHa and avoiding OHSS.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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