STUDY QUESTION<\/p>\n
Are there factors predicting the number of total and mature oocytes retrieved after controlled ovarian hyperstimulation (COH) utilizing a gonadotropin-releasing hormone (GnRH) antagonist protocol and a GnRH agonist (GnRHa) to induce oocyte maturation?<\/p>\n
SUMMARY ANSWER<\/p>\n
Peak estradiol (E2<\/SUB>) level, post-trigger LH and progesterone and the magnitude of LH rise are independent predictors of the total number of oocytes and mature oocytes retrieved.<\/p>\n WHAT IS KNOWN ALREADY<\/p>\n Despite multiple follicular development in high responders, oocyte retrieval after a GnRHa trigger in a small subset of patients fails to obtain a substantial number of total oocytes or mature oocytes.<\/p>\n STUDY DESIGN, SIZE AND DURATION<\/p>\n A retrospective chart review of all autologous and oocyte donation cycles utilizing a GnRHa antagonist protocol where GnRHa was used for the induction of oocyte maturation between 1 April 2003 and 31 December 2011.<\/p>\n PARTICIPANTS\/MATERIALS, SETTING AND METHODS<\/p>\n A total of 508 autologous and donor IVF\/ICSI cycles utilizing a GnRH antagonist protocol for COH and GnRHa for the induction of oocyte maturation at a university-based tertiary fertility center.<\/p>\n MAIN RESULTS AND THE ROLE OF CHANCE<\/p>\n Peak E2<\/SUB> on the day of trigger (r<\/I> = 0.19, P<\/I> < 0.001), post-trigger LH (r<\/I> = 0.12, P<\/I> = 0.009) and progesterone (r<\/I> = 0.47, P<\/I> < 001) and LH rise (r<\/I> = 0.18, P<\/I> < 0.001) all positively correlated with the number of total and mature oocytes retrieved. The true incidence of empty follicle syndrome was 1.4% (7\/508). There was no post-trigger LH or progesterone cut-off value for the prediction of oocyte yield. However, all cases of empty follicle syndrome occurred in patients with post-trigger LH <15 IU\/l and P<\/I> ≤ 3.5 ng\/ml. The findings of this study may also be due to chance since it was a retrospective study and not prospectively designed.<\/p>\n LIMITATION, REASONS FOR CAUTION<\/p>\n This is a retrospective chart review and therefore subject to bias. Serum hormone measurements were performed between 8 and 12 h after GnRHa trigger rather than a standardized time period following trigger administration. Therefore, peak levels of LH may have been missed due to the short ascending limb of LH rise lasting approximately 4 h after GnRHa trigger.<\/p>\n WIDER IMPLICATIONS OF THE FINDINGS<\/p>\n The results of this study can be generalized to high responders utilizing a GnRH antagonist protocol for COH and a GnRHa for the induction of oocyte maturation. The use of alternative stimulation regimens or medications will limit the ability to generalize the results of this study to other populations.<\/p>\n STUDY FUNDING\/COMPETING INTEREST(S)<\/p>\n This study was not funded, and there are no conflicts of interest.<\/p>\n TRIAL REGISTRATION NUMBER<\/p>\n n\/a<\/p>\n Source: STUDY QUESTION Are there factors predicting the number of total and mature oocytes retrieved after controlled ovarian hyperstimulation (COH) utilizing a gonadotropin-releasing hormone (GnRH) antagonist protocol and a GnRH agonist (GnRHa) to induce oocyte maturation? SUMMARY ANSWER Peak estradiol (E2) … Continue reading
http:\/\/humrep.oxfordjournals.org\/cgi\/content\/short\/28\/1\/152?rss=1<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"