Is the GnRH Antagonist Protocol Effective at Preventing OHSS for Potentially High Responders Undergoing IVF/ICSI?

Xing, Weijie; Lin, Haiyan; Li, Yu; Yang, Dongzi; Wang, Wenjun; Zhang, Qingxue
October 2015
PLoS ONE;10/15/2015, Vol. 10 Issue 10, p1
Academic Journal
Objective: To determine if the GnRH antagonist protocol is effective in preventing ovarian hyperstimulation syndrome (OHSS) in potentially high responders. Methods: A total of 660 IVF-ET/ICSI cycles were retrospectively identified. The inclusion criterion was age ≤ 30 years. Cycles were divided into two groups: a GnRHa group and a GnRHant group. In the GnRHa group, the patients received one single injection of 1.0mg-1.3mg Triptorelin in previous mid-luteal phase. In the GnRHant group, a daily dose of 0.25 mg Cetrotide was initiated when a lead follicle obtained a mean diameter of 14 mm, continued up until the day of hCG administration. The duration of stimulation, total dose of Gn, implantation rate, pregnancy rate, and OHSS rate were compared. Results: The duration of stimulation, E2 level on hCG day, numbers of oocytes retrieved, MII oocytes, and high-quality embryos in the GnRHa group were all significantly more than those in the GnRHant group. In the GnRHa group, 83.53% of cancelled fresh-transferred cycles were cancelled because of high risk of OHSS, which was significantly higher than that in the GnRHant group (43.55%, P<0.05). The incidence of OHSS in the GnRHa group was slightly higher than that in the GnRHant group. The implantation and clinical pregnancy rates in the GnRHa group were significantly higher than those in the GnRHant group (37.36% VS 19.25%, 62.78% VS 31.06%; P<0.05). Conclusions: Our study demonstrated that for potentially high responders, the GnRHant protocol can, to some extent, lower the cancellation and incidence rates of OHSS. The GnRHa protocol was superior to the GnRHant protocol in terms of implantation and clinical pregnancy rates.


Related Articles

  • Prediction of ovarian hyperstimulation syndrome in coasted patients in an IVF/ICSI program. Aljawoan, Fatimah Y.; Hunt, Linda P.; Gordon, Uma D. // Journal of Human Reproductive Sciences;Jan-Apr2012, Vol. 5 Issue 1, p32 

    AIM: To determine why a subgroup of coasted patients developed moderate/severe ovarian hyperstimulation syndrome (OHSS) in an assisted reproduction setting. MATERIALS AND METHODS: Retrospective study of 2948 in-vitro fertilization/ intracytoplasmic sperm injection (IVF/ICSI) treatment cycles...

  • Anticardiolipin Antibodies and Lupus Anticoagulants among Women Undergoing In Vitro Fertilization in Jamaica. DaCosta, V.; Chin, L.; Wynter, S.; Harriott, J.; Christie, L.; Frederick-Johnston, S.; Frederick, J.; McKenzie, C.; Everett, D.; Foster, R.; Walters, Y.; Pottinger, A. // West Indian Medical Journal;Nov2012, Vol. 61 Issue 8, p789 

    Objective: The aims of this study were to evaluate the effect of anticardiolipin antibody (aCL) and lupus anticoagulant (LA) on the outcome of the in vitro ferlitization (IVF) cycles and to determine the prevalence of these antibodies in infertile women seeking IVF in Jamaica. Methods: A...

  • Oncofertility: combination of ovarian stimulation with subsequent ovarian tissue extraction on the day of oocyte retrieval. Dittrich, Ralf; Lotz, Laura; Mueller, Andreas; Hoffmann, Inge; Wachter, David L.; Amann, Kerstin U.; Beckmann, Matthias W.; Hildebrandt, Thomas // Reproductive Biology & Endocrinology;2013, Vol. 11 Issue 1, p1 

    Background: New anticancer treatments have increased survival rates for cancer patients, but often at the cost of sterility. Several strategies are currently available for preserving fertility. However, the chances of achieving a pregnancy with one technique are still limited. A combination of...

  • Cumulative live-birth rate in women with polycystic ovary syndrome or isolated polycystic ovaries undergoing in-vitro fertilisation treatment. Li, Hang; Lee, Vivian; Lau, Estella; Yeung, William; Ho, Pak; Ng, Ernest // Journal of Assisted Reproduction & Genetics;Feb2014, Vol. 31 Issue 2, p205 

    Purpose: This retrospective cohort study evaluated the cumulative live birth rate in women with polycystic ovary syndrome (PCOS) and isolated polycystic ovaries (PCO) undergoing in-vitro fertilisation (IVF) treatment. Methods: We studied 104 women with PCOS, 184 with PCO and 576 age-matched...

  • Insight into in vitro Fertilization Cycle Cancellations. Ergun, Bulent; Sen, Serhat; Kuru, Oguzhan; Nehir, Asli; Bastu, Ercan // International Medical Journal;Feb2013, Vol. 20 Issue 1, p54 

    Introduction: In vitro fertilization (IVF) cycle cancellations may be related to poor response to gonadotropins, ovarian hyperstimulation syndrome (OHSS), etc. Our aim in this study was to evaluate why IVF cycles get cancelled, try to categorize the cancellations and propose approaches to...

  • Serum Oestradiol Pattern during Coasting is Different in Antagonist Cycles Compared with Long Agonist Cycles in In Vitro Fertilisation. Elter, Koray; Alev Özay, Tijen; Ergin, Elif; Hakan Özörnek, Murat // Balkan Medical Journal;Dec2013, Vol. 30 Issue 4, p406 

    Background: GnRH agonists and antagonists have different mechanism of action, and therefore serum estradiol levels might differ during coasting in IVF. Aims: To compare the change in serum oestradiol levels after withholding the gonadotropins for coasting between long agonist and antagonist...

  • Accelerated Coasting Does Not Affect Oocyte Maturation. Galal, Ahmed F.; Abbassy, Hadeer Aly; AbdElrahman, Ashraf Hany; Abdelhafez, Mohamed Sayed; Badawy, Ahmed // Gynecologic & Obstetric Investigation;Mar2018, Vol. 83 Issue 2, p145 

    Aims: The study aimed to assess the efficacy of accelerating the process of coasting through adding gonadotropin releasing hormone (GnRH) antagonist (GnRH-ant) on the day of triggering of oocyte maturation without withholding the GnRH agonist (GnRHa) in women at risk for developing...

  • Stroke as a complication of ovarian hyperstimulation syndrome: case report. Permadi, W.; Djuwantono, T.; Bayuaji, H.; Harlianto, H. // Reproductive BioMedicine Online (Reproductive Healthcare Limited;May2008 Supplement 2, Vol. 16 Issue S2, pS-23 

    Introduction: Ovarian hyperstimulation syndrome (OHSS) is a serious iatrogenic complication that can occur with ovarian stimulation in IVF, with incidence approximately 0.5--5%, and from those cases, only 0.04% of OHSS mainly manifested as a thromboembolic disease. We reported a case of stroke...

  • Non-Ergot Derived Dopamine Agonist Helps Prevent OHSS. Busso, Cristiano // Fertility Weekly;6/7/2010, p6 

    The article discusses the significant role of non-ergot derived dopamine in ovarian hyperstimulation syndrome (OHSS) particularly in patients undergoing in vitro fertilization (IVF). It looks at the multi-center study conducted by researchers to examine the feasibility of using dopamine agonist...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics