Urine LH testing may be useful to confirm an LH surge after the GnRH agonist (GnRHa) trigger prior to oocyte retrieval in IVF. A prospective cohort study, including oocyte donors undergoing ovarian stimulation, treated with a GnRHa trigger for final oocyte maturation. Urine LH testing was performed at home, 12 h after the GnRHa trigger. In the case of a negative result, serum LH and progesterone measurements were done that same day. Donors with no serum LH peak after trigger were re-scheduled using a dual trigger, with GnRHa and hCG. Three hundred and fifty nine oocyte donors were included in the analysis. Three hundred and fifty six donors had positive urine LH tests, followed by oocyte retrieval. In one case, the LH test was positive, however, no oocytes were retrieved (false positive 1/356). Three LH tests were negative in urine: in one of these three cases, LH was tested again in blood, confirming an LH rise, consistent with an optimal response to the GnRHa trigger; in the other two cases, serum LH was <15 mUI/mL, after which the oocyte retrieval was re-scheduled for 36 h after an being re-triggered, resulting in the retrieval of 19 and 22 MII oocytes, respectively. Considering the cost analysis, it would be a significantly cost-saving strategy, as blood testing would have costed 14,840€ vs. only 185.5€ in urine LH kits. Urinary testing of the LH surge after GnRHa trigger is easy, safe, reliable, and convenient. In addition, LH urine testing allows identifying donors and patients who could benefit from a rescue hCG trigger after an unsuccessful GnRHa trigger.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7189919 | PMC |
| http://dx.doi.org/10.3389/fendo.2020.00221 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
GnRH antagonist protocol with hCG triggering ameliorates fertilization defect caused by failure of cumulus cell pentraxin-3 expression in unilateral endometriomas.
Eur Rev Med Pharmacol Sci
October 2024
Department of Obstetrics and Gynecology, Bahcesehir University, Goztepe Medicalpark Hospital, Istanbul, Turkey.
Objective: The aim of the study was to determine the expression pattern of long pentraxin 3 (PTX3) mRNA in cumulus cells (CCs) isolated from metaphase II oocytes of women with unilateral endometrioma undergoing controlled ovarian stimulation using a gonadotropin-releasing hormone antagonist (GnRHa) protocol.
Patients And Methods: A total of 60 CC samples, 30 from the affected ovary and 30 from the contralateral ovary, were collected from 12 patients with unilateral endometrioma who underwent flexible GnRHa protocol with recombinant human chorionic gonadotropin (rhCG) trigger. Thirty CC samples collected from the left ovary of 12 women with male factor infertility were used as external controls.
A repeated gonadotropin-releasing hormone agonist trigger improves pregnancy outcomes of frozen-thawed embryo transfer in GnRH antagonist cycles: a retrospective propensity-matched score analysis.
J Assist Reprod Genet
December 2024
Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, No 1838 Guangzhou Northern Road, Guangzhou, 510515, People's Republic of China.
Article Synopsis
- * In the analysis of 712 women, the results showed that the group receiving repeated GnRHa triggers had significantly higher IVF fertilization rates, good-quality embryo rates, clinical pregnancy rates (CPR), and live birth rates (LBR) compared to the single GnRHa group.
- * The findings suggest that using a repeated GnRHa trigger is more effective for achieving better reproductive outcomes in frozen embryo transfer (FET) cycles.
GnRH antagonist impairs the process of embryo implantation by inhibiting motility of endometrial stromal cells through reducing c-kit expression.
Gynecol Endocrinol
December 2024
JXHC Key Laboratory of Fertility Preservation, Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi Province, China.
Article Synopsis
- The study examines the impact of gonadotropin-releasing hormone antagonist (GnRH-ant) versus agonist (GnRH-a) protocols on clinical outcomes in IVF-ET cycles, involving over 18,000 patients from a specific hospital in China.
- Results indicate patients using GnRH-ant had significantly lower endometrial thickness and poorer outcomes, including lower implantation, pregnancy, and live birth rates, along with a higher rate of early miscarriage compared to the GnRH-a group.
- Additionally, experiments on human endometrial stromal cells revealed that GnRH-ant treatment led to decreased expression of proteins linked to cell migration and adhesion, suggesting these molecular changes may contribute to the observed negative clinical outcomes.
Dual trigger or hCG alone: A retrospective analysis on patients with diminished ovarian reserve under in vitro fertilization and embryo transfer (IVF-ET) treatment.
Eur J Obstet Gynecol Reprod Biol
November 2024
Reproductive Medicine Center, Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China. Electronic address:
Article Synopsis
- The study looked at how effective two different methods of triggering ovulation are for women with fewer eggs (DOR) during in vitro fertilization (IVF).
- Researchers compared a dual-trigger method (using two medications) to a single method (using just one medication) to see if it made any difference in getting better results.
- The results showed that using both methods didn't provide any better outcomes for getting eggs or successful pregnancies than just using the single method alone.
Severe ovarian hyperstimulation syndrome following sole gonadotropin-releasing hormone (GnRH) agonist trigger: a case series and literature review.
Arch Gynecol Obstet
November 2024
Department of Obstetrics and Gynecology, Lis Hospital for Women's Health, Tel Aviv. Sourasky Medical Center, affiliated to the Faculty of Medicine, Tel Aviv University, 6423906, Tel Aviv, Israel.
Article Synopsis
- The study reports three cases of early severe ovarian hyperstimulation syndrome (OHSS) in patients treated with a GnRH antagonist protocol using a GnRH agonist trigger, which led to hospitalization and peritoneal drainage.
- All three patients displayed severe symptoms like abdominal distension and required supportive care; they showed significant improvement and complete recovery within 20 days post-hospitalization.
- The findings emphasize that using a GnRH agonist trigger may not fully prevent OHSS, indicating that clinicians should remain vigilant in managing such risks, even without administering hCG.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!