Intranasal gonadotropin-releasing hormone agonist (GnRHa) for luteal-phase support following GnRHa triggering, a novel approach to avoid ovarian hyperstimulation syndrome in high responders
Itai Bar-Hava, Yossi Mizrachi, Daphne Karfunkel-Doron, Yeela Omer, Liron Sheena, Nurit Carmon, Gila Ben-David, Itai Bar-Hava, Yossi Mizrachi, Daphne Karfunkel-Doron, Yeela Omer, Liron Sheena, Nurit Carmon, Gila Ben-David
Abstract
Objective: To study whether intranasal GnRH agonist (GnRHa) can be effectively used for luteal support in high-responder patients undergoing fresh-embryo transfer after ovulation induction with the use of GnRHa.
Design: Retrospective cohort study.
Setting: Private fertility clinic.
Patient(s): Forty-six high-responder patients were administered a GnRHa ovulation trigger to avoid ovarian hyperstimulation syndrome (OHSS), followed by 2 weeks of daily intranasal GnRHa (nafarelin) for luteal-phase support. No additional progesterone supplementation was administrated.
Intervention(s): Intranasal GnRHa for luteal-phase support.
Main outcome measure(s): The primary outcome was ongoing clinical pregnancy rate.
Result(s): High median progesterone levels were measured at midluteal phase and on the day of the first positive pregnancy test (190 nmol/L on both measures). We obtained 24 (52.1%) ongoing clinical pregnancies. None of the patients developed OHSS.
Conclusion(s): Intranasal GnRHa is effective in achieving luteal-phase support in high-responder patients triggered with GnRHa and avoiding OHSS.
Keywords: GnRH agonist; IVF; OHSS; luteal support.
Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Source: PubMed