Gonadotropin-releasing hormone agonist for ovulation trigger – OHSS prevention and use of modified luteal phase support for fresh embryo transfer
The introduction of gonadotrophin-releasing hormone agonist (GnRHa) trigger greatly impacted modern IVF treatment. Patients at low risk of ovarian hyperstimulation syndrome (OHSS) development, undergoing fresh embryo transfer and GnRHa trigger can be offered a virtually OHSS-free treatment with non-...
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doaj-91670b916d7542d9af41e4183447d6282021-04-02T18:06:50ZengUpsala Medical SocietyUpsala Journal of Medical Sciences0300-97342000-19672020-04-01125213113710.1080/03009734.2020.17366961736696Gonadotropin-releasing hormone agonist for ovulation trigger – OHSS prevention and use of modified luteal phase support for fresh embryo transferJuan Carlos Castillo0Thor Haahr1María Martínez-Moya2Peter Humaidan3Instituto BernabeuAarhus UniversityInstituto BernabeuAarhus UniversityThe introduction of gonadotrophin-releasing hormone agonist (GnRHa) trigger greatly impacted modern IVF treatment. Patients at low risk of ovarian hyperstimulation syndrome (OHSS) development, undergoing fresh embryo transfer and GnRHa trigger can be offered a virtually OHSS-free treatment with non-inferior reproductive outcomes by using a modified luteal phase support in terms of small boluses of human chorionic gonadotrophin (hCG), daily recombinant luteinizing hormone LH (rLH) or GnRHa. In the OHSS risk patient, GnRHa trigger can safely be performed, followed by a ‘freeze-all’ policy with a minimal risk of OHSS development and high live birth rates in the subsequent frozen embryo transfer cycle. Importantly, GnRHa trigger opened the ‘black box’ of the luteal phase, promoting research in the most optimal steroid levels during the luteal phase. GnRHa trigger allows high-dose gonadotropin stimulation to achieve the optimal number of oocytes and embryos needed to ensure the highest chance of live birth. This review thoroughly discusses how the GnRHa trigger concept adds safety and efficacy to modern IVF in terms of OHSS prevention. Furthermore, the optimal luteal phase management after GnRHa trigger in fresh embryo transfer cycles is discussed.http://dx.doi.org/10.1080/03009734.2020.1736696gnrha triggerhcgivfovarian hyperstimulation syndromeovulation trigger |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Juan Carlos Castillo Thor Haahr María Martínez-Moya Peter Humaidan |
spellingShingle |
Juan Carlos Castillo Thor Haahr María Martínez-Moya Peter Humaidan Gonadotropin-releasing hormone agonist for ovulation trigger – OHSS prevention and use of modified luteal phase support for fresh embryo transfer Upsala Journal of Medical Sciences gnrha trigger hcg ivf ovarian hyperstimulation syndrome ovulation trigger |
author_facet |
Juan Carlos Castillo Thor Haahr María Martínez-Moya Peter Humaidan |
author_sort |
Juan Carlos Castillo |
title |
Gonadotropin-releasing hormone agonist for ovulation trigger – OHSS prevention and use of modified luteal phase support for fresh embryo transfer |
title_short |
Gonadotropin-releasing hormone agonist for ovulation trigger – OHSS prevention and use of modified luteal phase support for fresh embryo transfer |
title_full |
Gonadotropin-releasing hormone agonist for ovulation trigger – OHSS prevention and use of modified luteal phase support for fresh embryo transfer |
title_fullStr |
Gonadotropin-releasing hormone agonist for ovulation trigger – OHSS prevention and use of modified luteal phase support for fresh embryo transfer |
title_full_unstemmed |
Gonadotropin-releasing hormone agonist for ovulation trigger – OHSS prevention and use of modified luteal phase support for fresh embryo transfer |
title_sort |
gonadotropin-releasing hormone agonist for ovulation trigger – ohss prevention and use of modified luteal phase support for fresh embryo transfer |
publisher |
Upsala Medical Society |
series |
Upsala Journal of Medical Sciences |
issn |
0300-9734 2000-1967 |
publishDate |
2020-04-01 |
description |
The introduction of gonadotrophin-releasing hormone agonist (GnRHa) trigger greatly impacted modern IVF treatment. Patients at low risk of ovarian hyperstimulation syndrome (OHSS) development, undergoing fresh embryo transfer and GnRHa trigger can be offered a virtually OHSS-free treatment with non-inferior reproductive outcomes by using a modified luteal phase support in terms of small boluses of human chorionic gonadotrophin (hCG), daily recombinant luteinizing hormone LH (rLH) or GnRHa. In the OHSS risk patient, GnRHa trigger can safely be performed, followed by a ‘freeze-all’ policy with a minimal risk of OHSS development and high live birth rates in the subsequent frozen embryo transfer cycle. Importantly, GnRHa trigger opened the ‘black box’ of the luteal phase, promoting research in the most optimal steroid levels during the luteal phase. GnRHa trigger allows high-dose gonadotropin stimulation to achieve the optimal number of oocytes and embryos needed to ensure the highest chance of live birth. This review thoroughly discusses how the GnRHa trigger concept adds safety and efficacy to modern IVF in terms of OHSS prevention. Furthermore, the optimal luteal phase management after GnRHa trigger in fresh embryo transfer cycles is discussed. |
topic |
gnrha trigger hcg ivf ovarian hyperstimulation syndrome ovulation trigger |
url |
http://dx.doi.org/10.1080/03009734.2020.1736696 |
work_keys_str_mv |
AT juancarloscastillo gonadotropinreleasinghormoneagonistforovulationtriggerohsspreventionanduseofmodifiedlutealphasesupportforfreshembryotransfer AT thorhaahr gonadotropinreleasinghormoneagonistforovulationtriggerohsspreventionanduseofmodifiedlutealphasesupportforfreshembryotransfer AT mariamartinezmoya gonadotropinreleasinghormoneagonistforovulationtriggerohsspreventionanduseofmodifiedlutealphasesupportforfreshembryotransfer AT peterhumaidan gonadotropinreleasinghormoneagonistforovulationtriggerohsspreventionanduseofmodifiedlutealphasesupportforfreshembryotransfer |
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1721552536478941184 |