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Individual luteolysis pattern after GnRH-agonist trigger for final oocyte maturation

Final oocyte maturation using GnRH-agonist trigger in a GnRH-antagonist protocol is increasingly common, as ovarian hyperstimulation syndrome is almost completely avoided. However, this approach might lead to reduced pregnancy rates due to severe luteolysis. This proof of concept study evaluated the...

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Autores principales: Lawrenz, Barbara, Garrido, Nicolas, Samir, Suzan, Ruiz, Francisco, Melado, Laura, Fatemi, Human M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5411051/
https://www.ncbi.nlm.nih.gov/pubmed/28459828
http://dx.doi.org/10.1371/journal.pone.0176600
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author Lawrenz, Barbara
Garrido, Nicolas
Samir, Suzan
Ruiz, Francisco
Melado, Laura
Fatemi, Human M.
author_facet Lawrenz, Barbara
Garrido, Nicolas
Samir, Suzan
Ruiz, Francisco
Melado, Laura
Fatemi, Human M.
author_sort Lawrenz, Barbara
collection PubMed
description Final oocyte maturation using GnRH-agonist trigger in a GnRH-antagonist protocol is increasingly common, as ovarian hyperstimulation syndrome is almost completely avoided. However, this approach might lead to reduced pregnancy rates due to severe luteolysis. This proof of concept study evaluated the extend of luteolysis by measuring progesterone levels 48 hours after oocyte retrieval in 51 patients, who received GnRH-agonist trigger for final oocyte maturation in a GnRH-antagonist protocol due to the risk of ovarian hyperstimulation syndrome. It was shown, that luteolysis after GnRHa-trigger differs greatly among patients, with progesterone levels ranging from 13.0 ng/ml to ≥ 60.0 ng/ml, 48 hours after oocyte retrieval. Significant positive correlations could be demonstrated between progesterone levels and the number of ovarian stimulation and suppression days (p = 0.006 and p = 0.002 respectively), the total amount of medication used for ovarian suppression (p = 0.015), the level of progesterone on the day of final oocyte maturation (p = 0.008) and the number of retrieved oocytes (p = 0.019). Therefore it was concluded, that luteolysis after GnRH-agonist trigger is patient-specific and also luteal phase support requires individualization. Longer stimulation duration as well as a higher level of progesterone on the day of final oocyte maturation and more retrieved oocytes will result in higher levels of progesterone 48 hours after oocyte retrieval.
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spelling pubmed-54110512017-05-12 Individual luteolysis pattern after GnRH-agonist trigger for final oocyte maturation Lawrenz, Barbara Garrido, Nicolas Samir, Suzan Ruiz, Francisco Melado, Laura Fatemi, Human M. PLoS One Research Article Final oocyte maturation using GnRH-agonist trigger in a GnRH-antagonist protocol is increasingly common, as ovarian hyperstimulation syndrome is almost completely avoided. However, this approach might lead to reduced pregnancy rates due to severe luteolysis. This proof of concept study evaluated the extend of luteolysis by measuring progesterone levels 48 hours after oocyte retrieval in 51 patients, who received GnRH-agonist trigger for final oocyte maturation in a GnRH-antagonist protocol due to the risk of ovarian hyperstimulation syndrome. It was shown, that luteolysis after GnRHa-trigger differs greatly among patients, with progesterone levels ranging from 13.0 ng/ml to ≥ 60.0 ng/ml, 48 hours after oocyte retrieval. Significant positive correlations could be demonstrated between progesterone levels and the number of ovarian stimulation and suppression days (p = 0.006 and p = 0.002 respectively), the total amount of medication used for ovarian suppression (p = 0.015), the level of progesterone on the day of final oocyte maturation (p = 0.008) and the number of retrieved oocytes (p = 0.019). Therefore it was concluded, that luteolysis after GnRH-agonist trigger is patient-specific and also luteal phase support requires individualization. Longer stimulation duration as well as a higher level of progesterone on the day of final oocyte maturation and more retrieved oocytes will result in higher levels of progesterone 48 hours after oocyte retrieval. Public Library of Science 2017-05-01 /pmc/articles/PMC5411051/ /pubmed/28459828 http://dx.doi.org/10.1371/journal.pone.0176600 Text en © 2017 Lawrenz et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Lawrenz, Barbara
Garrido, Nicolas
Samir, Suzan
Ruiz, Francisco
Melado, Laura
Fatemi, Human M.
Individual luteolysis pattern after GnRH-agonist trigger for final oocyte maturation
title Individual luteolysis pattern after GnRH-agonist trigger for final oocyte maturation
title_full Individual luteolysis pattern after GnRH-agonist trigger for final oocyte maturation
title_fullStr Individual luteolysis pattern after GnRH-agonist trigger for final oocyte maturation
title_full_unstemmed Individual luteolysis pattern after GnRH-agonist trigger for final oocyte maturation
title_short Individual luteolysis pattern after GnRH-agonist trigger for final oocyte maturation
title_sort individual luteolysis pattern after gnrh-agonist trigger for final oocyte maturation
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5411051/
https://www.ncbi.nlm.nih.gov/pubmed/28459828
http://dx.doi.org/10.1371/journal.pone.0176600
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