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Does the repeat dose of gonadotropin-releasing hormone agonist trigger in polycystic ovarian syndrome improve in vitro fertilization cycles outcome? A clinical trial study
Aflatoonian, Abbas; Haghighi, Fatemeh; Hoseini, Masrooreh & Haghdani, Saeid
Abstract
Background: A repeat dose of Gonadotropin-releasing Hormone (GnRH) agonist could
provide long duration of luteinizing hormone (LH) surge and amplitude appropriately.
Objective: Improvement in oocyte maturity could be obtained by a repeat dose of
GnRH agonist.
Materials and Methods: In this randomized double-blinded study, 120 women with
polycystic ovarian syndrome and serum estradiol level (E2) > 3000 who were candidate
for in vitro fertilization with Antagonist protocol were enrolled between July 2018 and
July 2019. Participants were randomized in two groups - and final oocyte maturation
was triggered with two doses: In group A, a repeat dose of 0.1 mg, 12 hr. after the first
dose and in group B, 0.2 mg SC triptorelin (decapeptyl) 35 hr. prior to oocyte retrieval.
Serum Estradiol, LH, and progesterone concentration were measured on the trigger
day. Serum LH measurement was done three times in both groups. The outcomes were
oocyte yield, meiosis (M) I, MII, Maturity rate, germinal vesicle (GV) rate, 2 pronuclear,
embryo yield, ovarian hyper stimulation syndrome rates.
Results: Maturity rate (p = 0.89), MI (p = 0.38), MII (p = 0.89), and GV oocytes (p = 0.38)
were not statistically different between the two study groups. LH levels measured at 12
hr post-trigger did not relate statistically significant with maturity rate in our participants
(p = 0.96). No empty follicular syndrome was reported.
Conclusion: Although, the second dose of GnRH agonist after 12 hr since the first dose
could provide duration of LH surge and amplitude and as a result no empty follicular
syndrome was seen, the maturity rate, MI, MII, and GV oocytes were not different
between the two study groups.
Keywords
Polycystic ovarian syndrome; Treatment; In vitro fertilization; Gonadotropin-Releasing hormone.
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