Gonadotropin releasing hormone agonist trigger in oocyte donors co-treated with a gonadotropin releasing hormone antagonist: a dose finding study

Comparable numbers of mature oocytes and top quality embryos are retrieved after the use of triptorelin doses of 0.2, 0.3, or 0.4 mg to trigger ovulation in oocyte donors.

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Authors

Vuong Thi Ngoc Lan, M.D., Ho Manh Tuong, M.D., Ha Tan Duc, M.D., Phung Huy Tuan, M.D., Huynh Gia Bao, M.D., Peter Humaidan, D.M.Sc.

Volume 105, Issue 2, Pages 356-363

Abstract

Objective:

To determine the optimal GnRH agonist dose for triggering of oocyte maturation in oocyte donors.

Design:

Single-center, randomized, parallel, investigator-blinded trial.

Setting:

IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam.

Patient(s):

One hundred sixty-five oocyte donors (aged 18–35 years, body mass index [BMI] <28 kg/m2, antimüllerian hormone level >1.25 ng/mL, and antral follicle count ≥6).

Intervention(s):

Ovulation trigger with 0.2, 0.3, or 0.4 mg triptorelin in a GnRH antagonist cycle.

Main Outcome Measure(s):

The primary end point was number of metaphase II oocytes. Secondary end points were fertilization and cleavage rates, number of embryos and top-quality embryos, steroid levels, ovarian volume, and ongoing pregnancy rate (PR) in recipients.

Result(s):

There were no significant differences between the triptorelin 0.2, 0.3, and 0.4 mg trigger groups with respect to number of metaphase II (16.0 ± 8.5, 15.9 ± 7.8, and 14.7 ± 8.4, respectively), embryos (13.2 ± 7.8, 11.7 ± 6.9, 11.8 ± 7.0), and number of top-quality embryos (3.8 ± 2.9, 3.6 ± 3.0, 4.1 ± 3.0). Luteinizing hormone levels at 24 hours and 36 hours after trigger was significantly higher with triptorelin 0.4 mg versus 0.2 mg and 0.3 mg (9.8 ± 7.1 IU/L vs. 7.3 ± 4.1 IU/L and 7.2 ± 3.7 IU/L, respectively; 4.6 ± 3.2 IU/L vs. 3.2 ± 2.3 IU/L and 3.3 ± 2.1 IU/L, respectively. Progesterone level at oocyte pick-up +6 days was significantly higher in the 0.4-mg group (2.2 ± 3.7 IU/L) versus 0.2 mg (1.1 ± 1.0 IU/L) and 0.3 mg (1.2 ± 1.6 IU/L). One patient developed early-onset severe ovarian hyperstimulation syndrome (OHSS).

Conclusion(s):

No significant differences between triptorelin doses of 0.2, 0.3, and 0.4 mg used for ovulation trigger in oocyte donors were seen with regard to the number of mature oocytes and top-quality embryos.

Clinical Trial Registration Number:

NCT02208986.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)02021-X/fulltext

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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