The benefit of individualized low-dose hCG support for high responders in GnRHa-triggered IVF/ICSI cycles

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• 作者：Chen-Yu Huang^a ; ^b ; Miawh-Lirng Shieh^a ; Hsin-Yang Li^a ; ^b ; ^{lihy@vghtpe.gov.tw" class="auth_mail" title="E-mail the corresponding author}
• 关键词：agonist trigger ; high responders ; human chorionic gonadotropin (hCG) ; in vitro fertilization (IVF) ; ovarian hyperstimulation syndrome (OHSS)
• 刊名：Journal of the Chinese Medical Association
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：79
• 期：7
• 页码：387-393
• 全文大小：518 K

文摘

To assess the pregnancy outcome and ovarian hyperstimulation syndrome (OHSS) incidence in high responders receiving gonadotropin-releasing hormone agonist (GnRHa) trigger plus individualized support of low-dose human chorionic gonadotropin (hCG). Such support includes 500–1000 IU hCG given at trigger and, if serum estradiol (E₂) dropped to below 800 pg/mL before the 6^th day after oocyte retrieval, an additional rescue dose of 300 IU hCG.

Methods

This was a retrospective study of potential high responders aged from 28 years to 40 years at a tertiary fertility center in Taiwan. By means of chart review, we assessed the pregnancy outcome and OHSS incidence in high responders receiving GnRHa trigger plus individualized low-dose hCG support. The main outcomes were measured by ongoing pregnancy rate and OHSS incidence (SPSS), in which statistical significance was determined by Chi-square test.

Results

Moderate to severe OHSS did not develop in any patient receiving GnRHa trigger plus individualized low-dose hCG support. In fact, a satisfactory ongoing pregnancy rate (46.9%) was noted in patients receiving GnRHa trigger plus individualized low-dose hCG support.

Conclusion

Our study suggested that GnRHa trigger combined with individualized low-dose hCG support appears to be a safe approach with a satisfactory pregnancy outcome.