Ovarian Hyperstimulation Syndrome Ratio And In Vitro Fertilization Success With Gonadotrphine Releasing Hormone Trigger And 1500 IU Human Chorionic Gonadotrophine For Luteal Support

Abstract

Ayca Nazli BULUT, Semih Zeki ULUDAG, Mustafa Ercan AYGEN and Yilmaz SAHIN

Intraduction: Ovarian hyperstimulation syndrome (OHSS) is very serius complication of in vitro fertilisation (IVF) treatments. Human chorionic gonadotrophine (hCG) is the trigger factor of the syndrome. Gonadotrophine releasing hormone agonist (GnRHa) can use instead of hCG for triggering the ovulation.

Matherial and Methods: This study aims to evaluate the effects of ovulation triggering with Gonadotrophine Releasing Hormone Agonists (GnRHa) on ovarian hyperstimulation syndrome (OHSS) rates and pregnancy success in patients at risk of OHSS. 51 cycles were evaluated in 50 women. Gonadotrophine (Gn) was applied to all patients with a flexible GnRHa protocol. To trigger ovulation, 0.2 mg triptorelin was applied when the estradiol level was 3500-7000 pg/mL and/or when at least 18 follicles were determined at ≥10mm. Oocyte Pick-Up (OPU) was performed 35 hours after the triptorelin injection. Within 1 hour of OPU, luteal support with 1500 IU hCG was administered to the patients and on the night of OPU, vaginal progesterone and oral estrogen were started.

Results: OHSS was determined in 5 cycles (9.8%), and 4 of them (7.8%) were early OHSS. Embryo transfer was applied in 49 cycles. The pregnancy rate was determined as 44.9%, clinical pregnancy rate as 26.5%, continuing pregnancy rate as 24.4% and the abortus rate as 2%.

Conclusion: GnRHa triggering applied before treatment to patients at risk of early OHSS does not completely eliminate the risk of OHSS. Nevertheless, this protocol improved treatment results without increasing the rates of severe OHSS.

PDF