Paper Information

Journal:   INTERNATIONAL JOURNAL OF REPRODUCTIVE BIOMEDICINE (IRANIAN JOURNAL OF REPRODUCTIVE MEDICINE)   January 2018 , Volume 16 , Number 1; Page(s) 9 To 18.
 
Paper: 

Fresh versus frozen embryo transfer after gonadotropinreleasing hormone agonist trigger in gonadotropinreleasing hormone antagonist cycles among high responder women: A randomized, multi-center study

 
 
Author(s):  AFLATOONIAN ABBAS, MANSOORI TORSHIZI MAHNAZ, FARID MOJTAHEDI MARYAM, Khalili Mohammaad Ali, AMIR ARJMAND MOHAMMAD HOSSEIN, SOLEIMANI MEHRDAD, AFLATOONIAN NASTARAN, Oskouian Homa, TABIBNEJAD NASIM*, HUMAIDAN PETER*
 
* Fertility Clinic, Skive Regional Hospital and Faculty of Health, Aarhus University, Aarhus, Denmark
 
Abstract: 
Background: The use of embryo cryopreservation excludes the possible detrimental effects of ovarian stimulation on the endometrium, and higher reproductive outcomes following this policy have been reported. Moreover, gonadotropinreleasing hormone agonist trigger in gonadotropin-releasing hormone (GnRH) antagonist cycles as a substitute for standard human chorionic gonadotropin trigger, minimizes the risk of ovarian hyperstimulation syndrome (OHSS) in fresh as well as frozen embryo transfer cycles (FET). Objective: To compare the reproductive outcomes and risk of OHSS in fresh vs frozen embryo transfer in high responder patients, undergoing in vitro fertilization triggered with a bolus of GnRH agonist. Materials and Methods: In this randomized, multi-centre study, 121 women undergoing FET and 119 women undergoing fresh ET were investigated as regards clinical pregnancy as the primary outcome and the chemical pregnancy, live birth, OHSS development, and perinatal data as secondary outcomes. Results: There were no significant differences between FET and fresh groups regarding chemical (46. 4% vs. 40. 2%, p=0. 352), clinical (35. 8% vs. 38. 3%, p=0. 699), and ongoing (30. 3% vs. 32. 7%, p=0. 700) pregnancy rates, also live birth (30. 3% vs. 29. 9%, p=0. 953), perinatal outcomes, and OHSS development (35. 6% vs. 42. 9%, p=0. 337). No woman developed severe OHSS and no one required admission to hospital. Conclusion: Our findings suggest that GnRHa trigger followed by fresh transfer with modified luteal phase support in terms of a small human chorionic gonadotropin bolus is a good strategy to secure good live birth rates and a low risk of clinically relevant OHSS development in in vitro fertilization patients at risk of OHSS.
 
Keyword(s): Fresh embryo transfer,Fresh,Frozen-thawed embryo transfer,GnRH antagonist,GnRHa trigger,OHSS,Reproductive Outcome
 
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