Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
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The effectiveness of earlier oocyte retrieval in the case of a premature luteinizing hormone surge on hCG day in in vitro fertilization-embryo transfer cycles

  • Choi, Min Hye (Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital, Kwandong University College of Medicine) ;
  • Cha, Sun Hwa (Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital, Kwandong University College of Medicine) ;
  • Park, Chan Woo (Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital, Kwandong University College of Medicine) ;
  • Kim, Jin Young (Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital, Kwandong University College of Medicine) ;
  • Yang, Kwang Moon (Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital, Kwandong University College of Medicine) ;
  • Song, In Ok (Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital, Kwandong University College of Medicine) ;
  • Koong, Mi Kyoung (Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital, Kwandong University College of Medicine) ;
  • Kang, Inn Soo (Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital, Kwandong University College of Medicine) ;
  • Kim, Hye Ok (Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital, Kwandong University College of Medicine)
  • Received : 2013.06.03
  • Accepted : 2013.06.18
  • Published : 2013.06.30
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Abstract

Objective: To evaluate the efficacy of earlier oocyte retrieval in IVF patients with a premature LH surge on hCG day. Methods: One hundred forty IVF patients (164 cycles) with premature LH surge on hCG day were included, retrospectively. We divided them into 2 study groups: LH surge with timed ovum pick-up (OPU) 36 hours after hCG injection (group B, 129 premature cycles), and LH surge with earlier OPU within 36 hours after hCG injection (group C, 35 cycles). Control groups were tubal factor infertility without premature LH surge (group A, 143 cycles). Results: The mean age (year) was statistically higher in group C than in groups A or B ($38.2{\pm}5.4$ vs. $36.2{\pm}4.2$ vs. $36.8{\pm}4.9$, respectively; p=0.012). The serum LH levels (mIU/mL) on hCG day were significantly higher in group B and C than in group A ($22.7{\pm}14.9$ vs. $30.3{\pm}15.9$ vs. $3.2{\pm}2.9$, respectively; p>0.001). Among groups A, B, and C, 4.9%, 31.7%, and 51.4% of the cycles, respectively, had no oocytes, and the overall rates of cycle cancellation (OPU cancellation, no oocyte, or no embryos transferrable) were 15.4%, 65.9%, and 74.3%, respectively. The fertilization rate (%) was significantly higher in group B than in group C ($73.2{\pm}38.9$ vs. $47.8{\pm}42.9$, p=0.024). The clinical pregnancy rate was significantly higher in group C than in groups A and B (44.4% vs. 27.3% vs. 9.1%, respectively, p=0.021). However, the miscarriage rate was also higher in group C than in group B (22% vs. 0%, respectively, p=0.026). Conclusion: Earlier OPU may not be effective in reducing the risk of cycle cancellation in patients with premature LH surge on hCG day. A larger scale study will be required to reveal the effectiveness of earlier ovum retrieval with premature LH surge.

Keywords

References

  1. Hortin G, Natowicz M, Pierce J, Baenziger J, Parsons T, Boime I. Metabolic labeling of lutropin with [35S]sulfate. Proc Natl Acad Sci U S A 1981;78:7468-72. https://doi.org/10.1073/pnas.78.12.7468
  2. Griesinger G, Kolibianakis EM, Papanikolaou EG, Diedrich K, Van Steirteghem A, Devroey P, et al. Triggering of final oocyte maturation with gonadotropin-releasing hormone agonist or human chorionic gonadotropin. Live birth after frozen-thawed embryo replacement cycles. Fertil Steril 2007;88:616-21. https://doi.org/10.1016/j.fertnstert.2006.12.006
  3. Wang W, Zhang XH, Wang WH, Liu YL, Zhao LH, Xue SL, et al. The time interval between hCG priming and oocyte retrieval in ART program: a meta-analysis. J Assist Reprod Genet 2011;28:901-10. https://doi.org/10.1007/s10815-011-9613-x
  4. Droesch K, Muasher SJ, Kreiner D, Jones GS, Acosta AA, Rosenwaks Z. Timing of oocyte retrieval in cycles with a spontaneous luteinizing hormone surge in a large in vitro fertilization program. Fertil Steril 1988;50:451-6. https://doi.org/10.1016/S0015-0282(16)60131-0
  5. Mansour RT, Aboulghar MA, Serour GI. Study of the optimum time for human chorionic gonadotropin-ovum pickup interval in in vitro fertilization. J Assist Reprod Genet 1994;11:478-81. https://doi.org/10.1007/BF02215712
  6. Thornton SJ, Pepperell RJ, Brown JB. Home monitoring of gonadotropin ovulation induction using the Ovarian Monitor. Fertil Steril 1990;54:1076-82. https://doi.org/10.1016/S0015-0282(16)54008-4
  7. Barri PN, Coroleu B, Martinez F, Veiga A. Stimulation protocols for poor responders and aged women. Mol Cell Endocrinol 2000; 166:15-20. https://doi.org/10.1016/S0303-7207(00)00292-6
  8. Ferraretti AP, Gianaroli L, Magli MC, Bafaro G, Colacurci N. Female poor responders. Mol Cell Endocrinol 2000;161:59-66. https://doi.org/10.1016/S0303-7207(99)00225-7
  9. Olivennes F, Belaisch-Allart J, Emperaire JC, Dechaud H, Alvarez S, Moreau L, et al. Prospective, randomized, controlled study of in vitro fertilization-embryo transfer with a single dose of a luteinizing hormone-releasing hormone (LH-RH) antagonist (cetrorelix) or a depot formula of an LH-RH agonist (triptorelin). Fertil Steril 2000;73:314-20. https://doi.org/10.1016/S0015-0282(99)00524-5
  10. Lambalk CB, Leader A, Olivennes F, Fluker MR, Andersen AN, Ingerslev J, et al. Treatment with the GnRH antagonist ganirelix prevents premature LH rises and luteinization in stimulated intrauterine insemination: results of a double-blind, placebo-con trolled, multicentre trial. Hum Reprod 2006;21:632-9. https://doi.org/10.1093/humrep/dei386
  11. A double-blind, randomized, dose-finding study to assess the efficacy of the gonadotrophin-releasing hormone antagonist ganirelix (Org 37462) to prevent premature luteinizing hormone surges in women undergoing ovarian stimulation with recombinant follicle stimulating hormone (Puregon). The ganirelix dosefinding study group. Hum Reprod 1998;13:3023-31. https://doi.org/10.1093/humrep/13.11.3023
  12. Dovey S, McIntyre K, Jacobson D, Catov J, Wakim A. Is a premature rise in luteinizing hormone in the absence of increased progesterone levels detrimental to pregnancy outcome in GnRH antagonist in vitro fertilization cycles. Fertil Steril 2011;96:585-9. https://doi.org/10.1016/j.fertnstert.2011.06.042
  13. Allegra A, Marino A, Coffaro F, Scaglione P, Sammartano F, Rizza G, et al. GnRH antagonist-induced inhibition of the premature LH surge increases pregnancy rates in IUI-stimulated cycles. A prospective randomized trial. Hum Reprod 2007;22:101-8. https://doi.org/10.1093/humrep/dem1065
  14. Sonmezer M, Pelin Cil A, Atabekoglu C, Ozkavukcu S, Ozmen B. Does premature luteinization or early surge of LH impair cycle outcome? Report of two successful outcomes. J Assist Reprod Genet 2009;26:159-63. https://doi.org/10.1007/s10815-009-9299-5
  15. Diedrich K, Diedrich C, Santos E, Zoll C, al-Hasani S, Reissmann T, et al. Suppression of the endogenous luteinizing hormone surge by the gonadotrophin-releasing hormone antagonist Cetrorelix during ovarian stimulation. Hum Reprod 1994;9:788-91.
  16. Felberbaum RE, Reissmann T, Kupker W, Bauer O, al Hasani S, Diedrich C, et al. Preserved pituitary response under ovarian stimulation with HMG and GnRH antagonists (Cetrorelix) in women with tubal infertility. Eur J Obstet Gynecol Reprod Biol 1995;61: 151-5. https://doi.org/10.1016/0301-2115(95)02138-W
  17. Frydman R, Cornel C, de Ziegler D, Taieb J, Spitz IM, Bouchard P. Prevention of premature luteinizing hormone and progesterone rise with a gonadotropin-releasing hormone antagonist, Nal-Glu, in controlled ovarian hyperstimulation. Fertil Steril 1991;56:923-7. https://doi.org/10.1016/S0015-0282(16)54666-4
  18. Frydman R, Cornel C, de Ziegler D, Taieb J, Spitz IM, Bouchard P. Spontaneous luteinizing hormone surges can be reliably prevented by the timely administration of a gonadotrophin releasing hormone antagonist (Nal-Glu) during the late follicular phase. Hum Reprod 1992;7:930-3. https://doi.org/10.1093/oxfordjournals.humrep.a137773
  19. Wilcox J, Potter D, Moore M, Ferrande L, Kelly E; CAP IV Investigator Group. Prospective, randomized trial comparing cetrorelix acetate and ganirelix acetate in a programmed, flexible protocol for premature luteinizing hormone surge prevention in assisted reproductive technologies. Fertil Steril 2005;84:108-17. https://doi.org/10.1016/j.fertnstert.2005.03.016

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