An additional rescue dose of GnRH antagonist administered the day before hCG trigger is effective to prevent ovarian hyperstimulation syndrome (OHSS) in IVF/ICSI antagonist cycles at risk for OHSS wit...

Mise à jour : Il y a 4 ans
Référence : ISRCTN02750360

An additional rescue dose of GnRH antagonist administered the day before hCG trigger is effective to prevent ovarian hyperstimulation syndrome (OHSS) in IVF/ICSI antagonist cycles at risk for OHSS without affecting the reproductive outcomes

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Background and study aims Gonadotrophin releasing hormone (GnRH) antagonists are compunds that are similar to the natural hormone but have an opposite effect. Treatment with GnRH antagonists lowers but does not eliminate the risk of ovarian hyperstimulation syndrome (OHSS) in hyper-responding patients who are undergoing in vitro fertilisation (IVF/ICSI cycles). A double daily GnRH antagonist dose given for 1-3 days before a process called human chorionic gonadotrophin (hCG) triggering seems to eliminate the risk of OHSS in oocyte donation cycles. In addition, GnRH agonist triggering for final oocyte maturation reduces pregnancy rates. The aim of this study was to find out the prevalence of early and late OHSS as well as the pregnancy rate in patients at risk for OHSS, stimulated with the antagonist who received a double dose of the antagonist regiment (Ganirelix) for a single day, with a reducing daily dose of follicle stimulating hormone (FSH). These patients were compared with a control group of patients at a high risk for OHSS who did not receive the double dose of the antagonist regiment, with a reducing dose of FSH. Who can participate? The study included patients at high risk for OHSS who underwent ovarian stimulation for IVF using the 6th day fixed GnRH antagonist method. Patients were aged above 18 years but younger than 40 years, with polycystic ovaries. What does the study involve? Participants were randomly allocated to one of two groups: Intervention Group A and Control Group B. Group A received a double dose of GnRH antagonist the day before hCG while control group B did not. In both groups FSH dosage was reduced to 100IU on the day of the allocation. What are the possible benefits and risks of participating? Patients can benefit by avoiding cancellation of their IVF cycle and proceed to fresh embryo transfer with safety. A rescue double GnRH antagonist dose the day before hCG trigger may effectively be a safe alternative preventive strategy for early and late OHSS without affecting the pregnancy outcomes. The main risks for the patients is that since the intervention proposed is new with lack of robust references regarding the safety of approach, OHSS can still occur and cycle cancellation might still be suggested as a preventive measure after all. Where is the study run from? The study is run from a private fertility centre IAKENTRO in Thessaloniki, Greece. When is study starting and how long is it expected to run for? This study was conducted from November 2009 to February 2013. Who is funding the study? IAKENTRO fertility centre (Greece). Who is the main contact? Professor Yannis Prapas, [email protected] Konstantinos Ravanos MD, MSc, [email protected]


Critère d'inclusion

  • Ovarian hyperstimulation syndrome (OHSS), ovarian stimulation, GnRH antagonist, IVF

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