Fertil Steril. 2016 May;105(5):1138-1143 – 2015-10-30
Thi Ngoc Lan Vuonga,b, Manh Tuong Hob,c, Tan Duc Had,e, Huy Tuan Phungb, Gia Bao Huynhb, and Peter Humaidanf,g
Published: October 30, 2015
Author information
a Department of Obstetrics and Gynaecology, University of Medicine and Pharmacy HCMC, Ho Chi Minh City, Vietnam;
b IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam;
c Research Center for Genetics and Reproductive Health (CGRH), School of Medicine, Vietnam National University HCMC, Ho Chi Minh City, Vietnam;
d National Hospital of Can Tho, Ho Chi Minh City, Vietnam;
e Ton Duc Thang University, Ho Chi Minh City, Vietnam;
f The Fertility Clinic, Skive Regional Hospital, Aarhus, Denmark;
g Faculty of Health, Aarhus University and Faculty of Health, University of Southern Denmark, Aarhus, Denmark
Abstract
Objective
To determine the optimal GnRH agonist dose for triggering of oocyte maturation in oocyte donors.
Design
Single-center, randomized, parallel, investigator-blinded trial.
Setting
IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam.
Patient(s)
One hundred sixty-five oocyte donors (aged 18–35 years, body mass index [BMI] <28 kg/m2, antimüllerian hormone level >1.25 ng/mL, and antral follicle count ≥6).
Intervention(s)
Ovulation trigger with 0.2, 0.3, or 0.4 mg triptorelin in a GnRH antagonist cycle.
Main Outcome Measure(s)
The primary end point was number of metaphase II oocytes. Secondary end points were fertilization and cleavage rates, number of embryos and top-quality embryos, steroid levels, ovarian volume, and ongoing pregnancy rate (PR) in recipients.
Result(s)
There were no significant differences between the triptorelin 0.2, 0.3, and 0.4 mg trigger groups with respect to number of metaphase II oocytes (16.0 ± 8.5, 15.9 ± 7.8, and 14.7 ± 8.4, respectively), embryos (13.2 ± 7.8, 11.7 ± 6.9, 11.8 ± 7.0), and number of top-quality embryos (3.8 ± 2.9, 3.6 ± 3.0, 4.1 ± 3.0). Luteinizing hormone levels at 24 hours and 36 hours after trigger was significantly higher with triptorelin 0.4 mg versus 0.2 mg and 0.3 mg (9.8 ± 7.1 IU/L vs. 7.3 ± 4.1 IU/L and 7.2 ± 3.7 IU/L, respectively; 4.6 ± 3.2 IU/L vs. 3.2 ± 2.3 IU/L and 3.3 ± 2.1 IU/L, respectively. Progesterone level at oocyte pick-up +6 days was significantly higher in the 0.4-mg group (2.2 ± 3.7 ng/ml) versus 0.2 mg (1.1 ± 1.0 ng/ml) and 0.3 mg (1.2 ± 1.6 ng/ml). One patient developed early-onset severe ovarian hyperstimulation syndrome (OHSS).
Conclusion(s)
No significant differences between triptorelin doses of 0.2, 0.3, and 0.4 mg used for ovulation trigger in oocyte donors were seen with regard to the number of mature oocytes and top-quality embryos.
Clinical Trial Registration Number
NCT02208986.
KEYWORDS:
In vitro fertilization, gonadotropin-releasing hormone agonist trigger, oocyte donor, dose-finding, triptorelin