GnRH agonist trigger in poor prognosis patients undergoing a multicycle approach through DuoStim or consecutive stimulations: a SWOT analysis.
Vaiarelli. Alberto A; Ruffa. Alessandro A; Cerrillo. María M; García-Velasco. Juan Antonio JA
Key Findings
- GnRH‑agonist trigger causes rapid luteolysis and does not impair the recruitment of the next follicular wave in DuoStim cycles
- It works as a safe alternative to hCG in freeze‑all IVF protocols
- Using the GnRH‑agonist does not reduce oocyte quality or overall IVF success rates
Practical Outcomes
- For IVF practitioners, swapping hCG for a GnRH‑agonist like triptorelin in double‑stimulation protocols can lower the risk of ovarian hyperstimulation and keep the next cycle’s egg yield stable. This approach is especially useful when planning to freeze all embryos before transfer.
Summary
The study looks at using a GnRH‑agonist drug (triptorelin) to trigger egg release in IVF cycles that involve back‑to‑back stimulations (DuoStim). It finds that this method safely causes the eggs to mature without hurting the next round of stimulation, making it a good alternative to the usual hCG trigger, especially when all embryos are frozen for later use.
Abstract
Identify the most recent and significant evidence regarding the ovulation trigger within the framework of a multicycle approach through DuoStim, providing valuable insights for improving treatment strategies in patients with a poor prognosis. The trigger method plays a pivotal role in optimizing in-vitro fertilization (IVF) stimulation, influencing oocyte retrieval and maturation rates, as well as follicle recruitment in consecutive ovarian stimulations such as double stimulation. Decision-making involves multiple factors and, while guidelines exist for conventional stimulation, specific recommendations for the multicycle approach are not well established. The different methods for inducing oocyte maturation underscore the need for personalization of IVF protocols. The GnRH agonist trigger induces rapid luteolysis and establishes favorable hormonal conditions that do not adversely affect the recruitment of consecutive follicular waves in the context of DuoStim. It serves as a valid alternative to hCG in freeze-all cycles. This strategy might enhance the safety and flexibility of ovarian stimulations with no impact on oocyte competence and IVF efficacy.
Study Information
pubmed
2024
2024-03-26T00:00:00.000Z
10.1097/gco.0000000000000947