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Repeated GnRH agonist doses for luteal support: a proof of concept.

Authors :
Wiser A
Klement AH
Shavit T
Berkovitz A
Koren RR
Gonen O
Amichay K
Shulman A
Source :
Reproductive biomedicine online [Reprod Biomed Online] 2019 Nov; Vol. 39 (5), pp. 770-776. Date of Electronic Publication: 2019 Jul 23.
Publication Year :
2019

Abstract

Research Question: What are the safety and feasibility of repeated subcutaneous doses of gonadotrophin-releasing hormone (GnRH) agonist for luteal support in IVF cycles triggered by a GnRH agonist?<br />Design: In this prospective trial, patients exhibiting oestradiol concentrations of over 2500 pg/ml after use of a GnRH agonist for triggering ovulation were initially randomized to GnRH agonist luteal support (0.1 mg subcutaneously every other day, starting on day 3 after embryo transfer) or to a control group supported by 80 µg of recombinant human chorionic gonadotrophin (HCG) on day 3 after embryo transfer. All patients underwent a day 5 blastocyst transfer. Randomization to the HCG luteal support was stopped owing to two cases of ovarian hyperstimulation syndrome (OHSS) and the study was continued solely with GnRH agonist luteal support.<br />Results: The study included 39 women in the repeated GnRH agonist luteal support group and seven in the HCG micro dose group. There were no cases of OHSS among patients supported by a GnRH agonist, and no other adverse events were recorded. There were no cases of bleeding before the pregnancy test, and hence no cases of an insufficient luteal phase. A clinical pregnancy rate of 43.6% was achieved with GnRH agonist luteal support. Hormone dynamics during the stimulation cycle reflected rising LH and progesterone concentrations after the introduction of GnRH agonist support.<br />Conclusions: Repeated doses of GnRH agonist every other day as a method of luteal support provided safe and effective luteal support for women who underwent GnRH agonist triggering in a GnRH antagonist IVF cycle.<br /> (Copyright © 2019 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)

Details

Language :
English
ISSN :
1472-6491
Volume :
39
Issue :
5
Database :
MEDLINE
Journal :
Reproductive biomedicine online
Publication Type :
Academic Journal
Accession number :
31628035
Full Text :
https://doi.org/10.1016/j.rbmo.2019.07.031