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GnRH Antagonist-Based Protocols for In Vitro Fertilization

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Human Fertility

Part of the book series: Methods in Molecular Biology ((MIMB,volume 1154))

Abstract

In this chapter we elaborate on the intricacies of employing GnRH antagonists for prevention of the endogenous luteinizing hormone surge during IVF. Several practical aspects of implementing a GnRH antagonist-based stimulation protocol are described; selection of the correct dose, choosing when to start the antagonist, programming of cycle starts, selection of the appropriate gonadotropins, and triggering of final oocyte maturation are elucidated.

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References

  1. Huirne JA, Lambalk CB (2001) Gonadotropin-releasing-hormone-receptor antagonists. Lancet 358:1793–1803

    Article  PubMed  CAS  Google Scholar 

  2. Borm G, Mannaerts B (2000) Treatment with the gonadotrophin-releasing hormone antagonist ganirelix in women undergoing ovarian stimulation with recombinant follicle stimulating hormone is effective, safe and convenient: results of a controlled, randomized, multicentre trial. The European Orgalutran Study Group. Hum Reprod 15:1490–1498

    Article  PubMed  CAS  Google Scholar 

  3. Matikainen T, Ding YQ, Vergara M, Huhtaniemi I, Couzinet B, Schaison G (1992) Differing responses of plasma bioactive and immunoreactive follicle-stimulating hormone and luteinizing hormone to gonadotropin-releasing hormone antagonist and agonist treatments in postmenopausal women. J Clin Endocrinol Metab 75:820–825

    PubMed  CAS  Google Scholar 

  4. Ludwig M, Felberbaum RE, Devroey P, Albano C, Riethmuller-Winzen H, Schuler A et al (2000) Significant reduction of the incidence of ovarian hyperstimulation syndrome (OHSS) by using the LHRH antagonist Cetrorelix (Cetrotide) in controlled ovarian stimulation for assisted reproduction. Arch Gynecol Obstet 264:29–32

    Article  PubMed  CAS  Google Scholar 

  5. Felberbaum RE, Albano C, Ludwig M, Riethmuller-Winzen H, Grigat M, Devroey P et al (2000) Ovarian stimulation for assisted reproduction with HMG and concomitant midcycle administration of the GnRH antagonist cetrorelix according to the multiple dose protocol: a prospective uncontrolled phase III study. Hum Reprod 15:1015–1020

    Article  PubMed  CAS  Google Scholar 

  6. Itskovitz-Eldor J, Kol S, Mannaerts B (2000) Use of a single bolus of GnRH agonist triptorelin to trigger ovulation after GnRH antagonist ganirelix treatment in women undergoing ovarian stimulation for assisted reproduction, with special reference to the prevention of ovarian hyperstimulation syndrome: preliminary report: short communication. Hum Reprod 15:1965–1968

    Article  PubMed  CAS  Google Scholar 

  7. Phillips A, Hahn DW, McGuire JL, Ritchie D, Capetola RJ, Bowers C et al (1988) Evaluation of the anaphylactoid activity of a new LHRH antagonist. Life Sci 43:883–888

    Article  PubMed  CAS  Google Scholar 

  8. Hahn DW, McGuire JL, Vale WW, Rivier J (1985) Reproductive/endocrine and anaphylactoid properties of an LHRH-antagonist, ORF 18260 [Ac-DNAL1(2), 4FDPhe2, D-Trp3, D-Arg6]-GnRH. Life Sci 37:505–514

    Article  PubMed  CAS  Google Scholar 

  9. Al-Inany HG, Abou-Setta AM, Aboulghar M (2006) Gonadotrophin-releasing hormone antagonists for assisted conception. Cochrane Database Syst Rev (3):CD001750

    Google Scholar 

  10. Al-Inany HG, Youssef MA, Aboulghar M, Broekmans F, Sterrenburg M, Smit J et al (2011) Gonadotrophin-releasing hormone antagonists for assisted reproductive technology. Cochrane Database Syst Rev (5):CD001750

    Google Scholar 

  11. De la Cruz A, Coy DH, Vilchez-Martinez JA, Arimura A, Schelly AV (1976) Blockage of ovulation in rats by inhibitory analogs of luteinizing hormones-releasing hormone. Science 191:195–197

    Article  PubMed  Google Scholar 

  12. Vilchez-Martinez JA, Schally AV, Coy DH, Coy EJ, Debeljuk L, Arimura A (1974) In vitro inhibition of LH release by a synthetic antagonist of LH-releasing hormone (LH-RH). Endocrinology 95:213–218

    Article  PubMed  CAS  Google Scholar 

  13. Cetel NS, Rivier J, Vale W, Yen SS (1983) The dynamics of gonadotropin inhibition in women induced by an antagonistic analog of gonadotropin-releasing hormone. J Clin Endocrinol Metab 57:62–65

    Article  PubMed  CAS  Google Scholar 

  14. Schmidt F, Sundaram K, Thau RB, Bardin CW (1984) [Ac-D-NAL(2)1,4FD-Phe2, D-Trp3, D-Arg6]-LHRH, a potent antagonist of LHRH, produces transient edema and behavioral changes in rats. Contraception 29:283–289

    Article  PubMed  CAS  Google Scholar 

  15. Bajusz S, Csernus VJ, Janaky T, Bokser L, Fekete M, Schally AV (1988) New antagonists of LHRH. II. Inhibition and potentiation of LHRH by closely related analogues. Int J Pept Protein Res 32:425–435

    Article  PubMed  CAS  Google Scholar 

  16. Albano C, Smitz J, Camus M, Riethmuller-Winzen H, Van Steirteghem A, Devroey P (1997) Comparison of different doses of gonadotropin-releasing hormone antagonist Cetrorelix during controlled ovarian hyperstimulation. Fertil Steril 67:917–922

    Article  PubMed  CAS  Google Scholar 

  17. (1998) 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 dose-finding study group. Hum Reprod 13:3023–3031

    Google Scholar 

  18. Dovey S, McIntyre K, Jacobson D, Catov J, Wakim A (2011) 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 96:585–589

    Article  PubMed  CAS  Google Scholar 

  19. Olivennes F, Alvarez S, Bouchard P, Fanchin R, Salat-Baroux J, Frydman R (1998) The use of a GnRH antagonist (Cetrorelix) in a single dose protocol in IVF-embryo transfer: a dose finding study of 3 versus 2 mg. Hum Reprod 13:2411–2414

    Article  PubMed  CAS  Google Scholar 

  20. Olivennes F, Diedrich K, Frydman R, Felberbaum RE, Howles CM (2003) Safety and efficacy of a 3 mg dose of the GnRH antagonist cetrorelix in preventing premature LH surges: report of two large multicentre, multinational, phase IIIb clinical experiences. Reprod Biomed Online 6:432–438

    Article  PubMed  CAS  Google Scholar 

  21. Olivennes F, Belaisch-Allart J, Emperaire JC, Dechaud H, Alvarez S, Moreau L et al (2000) 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 73:314–320

    Article  PubMed  CAS  Google Scholar 

  22. Wilcox J, Potter D, Moore M, Ferrande L, Kelly E (2005) 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 84:108–117

    Article  PubMed  CAS  Google Scholar 

  23. Lee TH, Wu MY, Chen HF, Chen MJ, Ho HN, Yang YS (2005) Ovarian response and follicular development for single-dose and multiple-dose protocols for gonadotropin-releasing hormone antagonist administration. Fertil Steril 83:1700–1707

    Article  PubMed  CAS  Google Scholar 

  24. Ludwig M, Katalinic A, Banz C, Schroder AK, Loning M, Weiss JM et al (2002) Tailoring the GnRH antagonist cetrorelix acetate to individual patients' needs in ovarian stimulation for IVF: results of a prospective, randomized study. Hum Reprod 17:2842–2845

    Article  PubMed  CAS  Google Scholar 

  25. Kolibianakis EM, Albano C, Kahn J, Camus M, Tournaye H, Van Steirteghem AC et al (2003) Exposure to high levels of luteinizing hormone and estradiol in the early follicular phase of gonadotropin-releasing hormone antagonist cycles is associated with a reduced chance of pregnancy. Fertil Steril 79:873–880

    Article  PubMed  Google Scholar 

  26. Escudero E, Bosch E, Crespo J, Simon C, Remohi J, Pellicer A (2004) Comparison of two different starting multiple dose gonadotropin-releasing hormone antagonist protocols in a selected group of in vitro fertilization-embryo transfer patients. Fertil Steril 81:562–566

    Article  PubMed  CAS  Google Scholar 

  27. Mochtar MH (2004) The effect of an individualized GnRH antagonist protocol on folliculogenesis in IVF/ICSI. Hum Reprod 19:1713–1718

    Article  PubMed  CAS  Google Scholar 

  28. Al-Inany H, Aboulghar MA, Mansour RT, Serour GI (2005) Optimizing GnRH antagonist administration: meta-analysis of fixed versus flexible protocol. Reprod Biomed Online 10:567–570

    Article  PubMed  CAS  Google Scholar 

  29. Kolibianakis EM, Venetis CA, Kalogeropoulou L, Papanikolaou E, Tarlatzis BC (2011) Fixed versus flexible gonadotropin-releasing hormone antagonist administration in in vitro fertilization: a randomized controlled trial. Fertil Steril 95:558–562

    Article  PubMed  CAS  Google Scholar 

  30. de Ziegler D, Jaaskelainen AS, Brioschi PA, Fanchin R, Bulletti C (1998) Synchronization of endogenous and exogenous FSH stimuli in controlled ovarian hyperstimulation (COH). Hum Reprod 13:561–564

    Article  PubMed  Google Scholar 

  31. Dragisic KG, Davis OK, Fasouliotis SJ, Rosenwaks Z (2005) Use of a luteal estradiol patch and a gonadotropin-releasing hormone antagonist suppression protocol before gonadotropin stimulation for in vitro fertilization in poor responders. Fertil Steril 84:1023–1026

    Article  PubMed  CAS  Google Scholar 

  32. Griesinger G, Kolibianakis EM, Venetis C, Diedrich K, Tarlatzis B (2010) Oral contraceptive pretreatment significantly reduces ongoing pregnancy likelihood in gonadotropin-releasing hormone antagonist cycles: an updated meta-analysis. Fertil Steril 94:2382–2384

    Article  PubMed  CAS  Google Scholar 

  33. Kim CH, Jeon GH, Cheon YP, Jeon I, Kim SH, Chae HD et al (2009) Comparison of GnRH antagonist protocol with or without oral contraceptive pill pretreatment and GnRH agonist low-dose long protocol in low responders undergoing IVF/intracytoplasmic sperm injection. Fertil Steril 92:1758–1760

    Article  PubMed  Google Scholar 

  34. Cedrin-Durnerin I, Bstandig B, Parneix I, Bied-Damon V, Avril C, Decanter C et al (2007) Effects of oral contraceptive, synthetic progestogen or natural estrogen pre-treatments on the hormonal profile and the antral follicle cohort before GnRH antagonist protocol. Hum Reprod 22:109–116

    Article  PubMed  CAS  Google Scholar 

  35. Kolibianakis EM, Papanikolaou EG, Camus M, Tournaye H, Van Steirteghem AC, Devroey P (2006) Effect of oral contraceptive pill pretreatment on ongoing pregnancy rates in patients stimulated with GnRH antagonists and recombinant FSH for IVF. A randomized controlled trial. Hum Reprod 21:352–357

    Article  PubMed  CAS  Google Scholar 

  36. Huirne JA, van Loenen AC, Donnez J, Pirard C, Homburg R, Schats R et al (2006) Effect of an oral contraceptive pill on follicular development in IVF/ICSI patients receiving a GnRH antagonist: a randomized study. Reprod Biomed Online 13:235–245

    Article  PubMed  CAS  Google Scholar 

  37. Rombauts L, Healy D, Norman RJ (2006) A comparative randomized trial to assess the impact of oral contraceptive pretreatment on follicular growth and hormone profiles in GnRH antagonist-treated patients. Hum Reprod 21:95–103

    Article  PubMed  CAS  Google Scholar 

  38. Pinkas H, Sapir O, Avrech OM, Ben-Haroush A, Ashkenzi J, Fisch B et al (2008) The effect of oral contraceptive pill for cycle scheduling prior to GnRH-antagonist protocol on IVF cycle parameters and pregnancy outcome. J Assist Reprod Genet 25:29–33

    Article  PubMed Central  PubMed  Google Scholar 

  39. Fanchin R, Salomon L, Castelo-Branco A, Olivennes F, Frydman N, Frydman R (2003) Luteal estradiol pre-treatment coordinates follicular growth during controlled ovarian hyperstimulation with GnRH antagonists. Hum Reprod 18:2698–2703

    Article  PubMed  CAS  Google Scholar 

  40. Fanchin R, Castelo Branco A, Kadoch IJ, Hosny G, Bagirova M, Frydman R (2004) Premenstrual administration of gonadotropin-releasing hormone antagonist coordinates early antral follicle sizes and sets up the basis for an innovative concept of controlled ovarian hyperstimulation. Fertil Steril 81:1554–1559

    Article  PubMed  CAS  Google Scholar 

  41. Weitzman VN, Engmann L, DiLuigi A, Maier D, Nulsen J, Benadiva C (2009) Comparison of luteal estradiol patch and gonadotropin-releasing hormone antagonist suppression protocol before gonadotropin stimulation versus microdose gonadotropin-releasing hormone agonist protocol for patients with a history of poor in vitro fertilization outcomes. Fertil Steril 92:226–230

    Article  PubMed  CAS  Google Scholar 

  42. Hill MJ, McWilliams GD, Miller KA, Scott RT Jr, Frattarelli JL (2009) A luteal estradiol protocol for anticipated poor-responder patients may improve delivery rates. Fertil Steril 91:739–743

    Article  PubMed  CAS  Google Scholar 

  43. Blockeel C, Engels S, De Vos M, Haentjens P, Polyzos NP, Stoop D et al (2012) Oestradiol valerate pretreatment in GnRH-antagonist cycles: a randomized controlled trial. Reprod Biomed Online 24:272–280

    Article  PubMed  CAS  Google Scholar 

  44. Popovic-Todorovic B, Loft A, Lindhard A, Bangsboll S, Andersson AM, Andersen AN (2003) A prospective study of predictive factors of ovarian response in ‘standard’ IVF/ICSI patients treated with recombinant FSH. A suggestion for a recombinant FSH dosage normogram. Hum Reprod 18:781–787

    Article  PubMed  CAS  Google Scholar 

  45. Olivennes F, Howles CM, Borini A, Germond M, Trew G, Wikland M et al (2009) Individualizing FSH dose for assisted reproduction using a novel algorithm: the CONSORT study. Reprod Biomed Online 18:195–204

    Article  PubMed  CAS  Google Scholar 

  46. Yovich J, Stanger J, Hinchliffe P (2012) Targeted gonadotrophin stimulation using the PIVEt algorithm markedly reduces the risk of OHSS. Reprod Biomed Online 24:281–292

    Article  PubMed  CAS  Google Scholar 

  47. Levy MJ, Ledger W, Kolibianakis EM, Ijzerman-Boon PC, Gordon K (2013) Is it possible to reduce the incidence of weekend oocyte retrievals in GnRH antagonist protocols? Reprod Biomed Online 26:50–58

    Article  PubMed  CAS  Google Scholar 

  48. Devroey P, Boostanfar R, Koper NP, Mannaerts BM, Ijzerman-Boon PC, Fauser BC (2009) A double-blind, non-inferiority RCT comparing corifollitropin alfa and recombinant FSH during the first seven days of ovarian stimulation using a GnRH antagonist protocol. Hum Reprod 24:3063–3072

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  49. Aboulghar MA, Mansour RT, Serour GI, Al-Inany HG, Amin YM, Aboulghar MM (2004) Increasing the dose of human menopausal gonadotrophins on day of GnRH antagonist administration: randomized controlled trial. Reprod Biomed Online 8:524–527

    Article  PubMed  CAS  Google Scholar 

  50. Propst AM, Bates GW, Robinson RD, Arthur NJ, Martin JE, Neal GS (2006) A randomized controlled trial of increasing recombinant follicle-stimulating hormone after initiating a gonadotropin-releasing hormone antagonist for in vitro fertilization-embryo transfer. Fertil Steril 86:58–63

    Article  PubMed  CAS  Google Scholar 

  51. Shapiro DB, Mitchell-Leef D, Carter M, Nagy ZP (2005) Ganirelix acetate use in normal- and poor-prognosis patients and the impact of estradiol patterns. Fertil Steril 83:666–670

    Article  PubMed  CAS  Google Scholar 

  52. Martin-Johnston M, Beltsos AN, Grotjan HE, Uhler ML (2007) Adding human menopausal gonadotrophin to antagonist protocols—is there a benefit? Reprod Biomed Online 15:161–168

    Article  PubMed  CAS  Google Scholar 

  53. Al-Inany HG, Abou-Setta AM, Aboulghar MA, Mansour RT, Serour GI (2009) Highly purified hMG achieves better pregnancy rates in IVF cycles but not ICSI cycles compared with recombinant FSH: a meta-analysis. Gynecol Endocrinol 25:372–378

    Article  PubMed  CAS  Google Scholar 

  54. van Wely M, Kwan I, Burt AL, Thomas J, Vail A, Van der Veen F et al (2011) Recombinant versus urinary gonadotrophin for ovarian stimulation in assisted reproductive technology cycles. Cochrane Database Syst Rev (2):CD005354

    Google Scholar 

  55. Bosch E, Vidal C, Labarta E, Simon C, Remohi J, Pellicer A (2008) Highly purified hMG versus recombinant FSH in ovarian hyperstimulation with GnRH antagonists—a randomized study. Hum Reprod 23:2346–2351

    Article  PubMed  CAS  Google Scholar 

  56. Kolibianakis EM, Kalogeropoulou L, Griesinger G, Papanikolaou EG, Papadimas J, Bontis J et al (2007) Among patients treated with FSH and GnRH analogues for in vitro fertilization, is the addition of recombinant LH associated with the probability of live birth? A systematic review and meta-analysis. Hum Reprod Update 13:445–452

    Article  PubMed  CAS  Google Scholar 

  57. Cedrin-Durnerin I, Grange-Dujardin D, Laffy A, Parneix I, Massin N, Galey J et al (2004) Recombinant human LH supplementation during GnRH antagonist administration in IVF/ICSI cycles: a prospective randomized study. Hum Reprod 19:1979–1984

    Article  PubMed  CAS  Google Scholar 

  58. Griesinger G, Schultze-Mosgau A, Dafopoulos K, Schroeder A, Schroer A, von Otte S et al (2005) Recombinant luteinizing hormone supplementation to recombinant follicle-stimulating hormone induced ovarian hyperstimulation in the GnRH-antagonist multiple-dose protocol. Hum Reprod 20:1200–1206

    Article  PubMed  CAS  Google Scholar 

  59. Levi-Setti PE, Cavagna M, Bulletti C (2006) Recombinant gonadotrophins associated with GnRH antagonist (cetrorelix) in ovarian stimulation for ICSI: comparison of r-FSH alone and in combination with r-LH. Eur J Obstet Gynecol Reprod Biol 126:212–216

    Article  PubMed  CAS  Google Scholar 

  60. Sauer MV, Thornton MH 2nd, Schoolcraft W, Frishman GN (2004) Comparative efficacy and safety of cetrorelix with or without mid-cycle recombinant LH and leuprolide acetate for inhibition of premature LH surges in assisted reproduction. Reprod Biomed Online 9:487–493

    Article  PubMed  CAS  Google Scholar 

  61. Mochtar MH, Van der V, Ziech M, van Wely M (2007) Recombinant luteinizing hormone (rLH) for controlled ovarian hyperstimulation in assisted reproductive cycles. Cochrane Database Syst Rev (2):CD005070

    Google Scholar 

  62. Kolibianakis EM, Albano C, Camus M, Tournaye H, Van Steirteghem AC, Devroey P (2004) Prolongation of the follicular phase in in vitro fertilization results in a lower ongoing pregnancy rate in cycles stimulated with recombinant follicle-stimulating hormone and gonadotropin-releasing hormone antagonists. Fertil Steril 82:102–107

    Article  PubMed  CAS  Google Scholar 

  63. Kolibianakis EM, Bourgain C, Papanikolaou EG, Camus M, Tournaye H, Van Steirteghem AC et al (2005) Prolongation of follicular phase by delaying hCG administration results in a higher incidence of endometrial advancement on the day of oocyte retrieval in GnRH antagonist cycles. Hum Reprod 20:2453–2456

    Article  PubMed  CAS  Google Scholar 

  64. Tremellen KP, Lane M (2010) Avoidance of weekend oocyte retrievals during GnRH antagonist treatment by simple advancement or delay of hCG administration does not adversely affect IVF live birth outcomes. Hum Reprod 25:1219–1224

    Article  PubMed  CAS  Google Scholar 

  65. Kyrou D, Kolibianakis EM, Fatemi HM, Tarlatzis BC, Tournaye H, Devroey P (2011) Is earlier administration of human chorionic gonadotropin (hCG) associated with the probability of pregnancy in cycles stimulated with recombinant follicle-stimulating hormone and gonadotropin-releasing hormone (GnRH) antagonists? A prospective randomized trial. Fertil Steril 96:1112–1115

    Article  PubMed  CAS  Google Scholar 

  66. Itskovitz J, Boldes R, Levron J, Erlik Y, Kahana L, Brandes JM (1991) Induction of preovulatory luteinizing hormone surge and prevention of ovarian hyperstimulation syndrome by gonadotropin-releasing hormone agonist. Fertil Steril 56:213–220

    PubMed  CAS  Google Scholar 

  67. Kummer NE, Feinn RS, Griffin DW, Nulsen JC, Benadiva CA, Engmann LL (2013) Predicting successful induction of oocyte maturation after gonadotropin-releasing hormone agonist (GnRHa) trigger. Hum Reprod 28:152–159

    Article  PubMed  CAS  Google Scholar 

  68. Griffin D, Benadiva C, Kummer N, Budinetz T, Nulsen J, Engmann L (2012) Dual trigger of oocyte maturation with gonadotropin-releasing hormone agonist and low-dose human chorionic gonadotropin to optimize live birth rates in high responders. Fertil Steril 97:1316–1320

    Article  PubMed  CAS  Google Scholar 

  69. Chen SL, Ye DS, Chen X, Yang XH, Zheng HY, Tang Y et al (2012) Circulating luteinizing hormone level after triggering oocyte maturation with GnRH agonist may predict oocyte yield in flexible GnRH antagonist protocol. Hum Reprod 27:1351–1356

    Article  PubMed  CAS  Google Scholar 

  70. Lewit N, Kol S, Manor D, Itskovitz-Eldor J (1996) Comparison of gonadotrophin-releasing hormone analogues and human chorionic gonadotrophin for the induction of ovulation and prevention of ovarian hyperstimulation syndrome: a case-control study. Hum Reprod 11:1399–1402

    Article  PubMed  CAS  Google Scholar 

  71. Imoedemhe DA, Chan RC, Sigue AB, Pacpaco EL, Olazo AB (1991) A new approach to the management of patients at risk of ovarian hyperstimulation in an in-vitro fertilization programme. Hum Reprod 6:1088–1091

    PubMed  CAS  Google Scholar 

  72. Kol S (2004) Luteolysis induced by a gonadotropin-releasing hormone agonist is the key to prevention of ovarian hyperstimulation syndrome. Fertil Steril 81:1–5

    Article  PubMed  CAS  Google Scholar 

  73. Babayof R, Margalioth EJ, Huleihel M, Amash A, Zylber-Haran E, Gal M et al (2006) Serum inhibin A, VEGF and TNFalpha levels after triggering oocyte maturation with GnRH agonist compared with HCG in women with polycystic ovaries undergoing IVF treatment: a prospective randomized trial. Hum Reprod 21:1260–1265

    Article  PubMed  CAS  Google Scholar 

  74. Engmann L, DiLuigi A, Schmidt D, Nulsen J, Maier D, Benadiva C (2008) The use of gonadotropin-releasing hormone (GnRH) agonist to induce oocyte maturation after cotreatment with GnRH antagonist in high-risk patients undergoing in vitro fertilization prevents the risk of ovarian hyperstimulation syndrome: a prospective randomized controlled study. Fertil Steril 89:84–91

    Article  PubMed  CAS  Google Scholar 

  75. Humaidan P, Ejdrup Bredkjaer H, Westergaard LG, Yding Andersen C (2010) 1,500 IU human chorionic gonadotropin administered at oocyte retrieval rescues the luteal phase when gonadotropin-releasing hormone agonist is used for ovulation induction: a prospective, randomized, controlled study. Fertil Steril 93:847–854

    Article  PubMed  CAS  Google Scholar 

  76. Acevedo B, Gomez-Palomares JL, Ricciarelli E, Hernandez ER (2006) Triggering ovulation with gonadotropin-releasing hormone agonists does not compromise embryo implantation rates. Fertil Steril 86:1682–1687

    Article  PubMed  CAS  Google Scholar 

  77. Galindo A, Bodri D, Guillen JJ, Colodron M, Vernaeve V, Coll O (2009) Triggering with HCG or GnRH agonist in GnRH antagonist treated oocyte donation cycles: a randomised clinical trial. Gynecol Endocrinol 25:60–66

    Article  PubMed  CAS  Google Scholar 

  78. Melo M, Busso CE, Bellver J, Alama P, Garrido N, Meseguer M et al (2009) GnRH agonist versus recombinant HCG in an oocyte donation programme: a randomized, prospective, controlled, assessor-blind study. Reprod Biomed Online 19:486–492

    Article  PubMed  CAS  Google Scholar 

  79. Sismanoglu A, Tekin HI, Erden HF, Ciray NH, Ulug U, Bahceci M (2009) Ovulation triggering with GnRH agonist vs. hCG in the same egg donor population undergoing donor oocyte cycles with GnRH antagonist: a prospective randomized cross-over trial. J Assist Reprod Genet 26:251–256

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  80. Hoff JD, Quigley ME, Yen SS (1983) Hormonal dynamics at midcycle: a reevaluation. J Clin Endocrinol Metab 57:792–796

    Article  PubMed  CAS  Google Scholar 

  81. Gonen Y, Balakier H, Powell W, Casper RF (1990) Use of gonadotropin-releasing hormone agonist to trigger follicular maturation for in vitro fertilization. J Clin Endocrinol Metab 71:918–922

    Article  PubMed  CAS  Google Scholar 

  82. Humaidan P, Bredkjaer HE, Bungum L, Bungum M, Grondahl ML, Westergaard L et al (2005) GnRH agonist (buserelin) or hCG for ovulation induction in GnRH antagonist IVF/ICSI cycles: a prospective randomized study. Hum Reprod 20:1213–1220

    Article  PubMed  CAS  Google Scholar 

  83. Engmann L, Benadiva C (2012) Agonist trigger: what is the best approach? Agonist trigger with aggressive luteal support. Fertil Steril 97:531–533

    Article  PubMed  CAS  Google Scholar 

  84. Garcia-Velasco JA (2012) Agonist trigger: what is the best approach? Agonist trigger with vitrification of oocytes or embryos. Fertil Steril 97:527–528

    Article  PubMed  Google Scholar 

  85. Humaidan P (2012) Agonist trigger: what is the best approach? Agonist trigger and low dose hCG. Fertil Steril 97:529–530

    Article  PubMed  CAS  Google Scholar 

  86. Benadiva C, Engmann L (2012) Intensive luteal phase support after GnRH agonist trigger: it does help. Reprod Biomed Online 25:329–330

    Article  PubMed  Google Scholar 

  87. Devroey P, Polyzos NP, Blockeel C (2011) An OHSS-Free Clinic by segmentation of IVF treatment. Hum Reprod 26:2593–2597

    Article  PubMed  Google Scholar 

  88. Griesinger G, Schultz L, Bauer T, Broessner A, Frambach T, Kissler S (2011) Ovarian hyperstimulation syndrome prevention by gonadotropin-releasing hormone agonist triggering of final oocyte maturation in a gonadotropin-releasing hormone antagonist protocol in combination with a “freeze-all” strategy: a prospective multicentric study. Fertil Steril 95:2029–2033, 2033.e1

    Article  PubMed  CAS  Google Scholar 

  89. Humaidan P, Kol S, Papanikolaou EG (2011) GnRH agonist for triggering of final oocyte maturation: time for a change of practice? Hum Reprod Update 17:510–524

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Center of Reproductive Medicine and Infertility, Weill Medical College of Cornell University, New York, NY, USA

    David Reichman M.D.

  2. The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, NY, USA

    Zev Rosenwaks M.D.

Authors
  1. David Reichman M.D.
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  2. Zev Rosenwaks M.D.
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Correspondence to David Reichman M.D. .

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Editors and Affiliations

  1. The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York, USA

    Zev Rosenwaks

  2. Dept. Developmental & Regenerative Biology, Ichan School of Medicine at Mount Sinai, New York, New York, USA

    Paul M. Wassarman

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Reichman, D., Rosenwaks, Z. (2014). GnRH Antagonist-Based Protocols for In Vitro Fertilization. In: Rosenwaks, Z., Wassarman, P. (eds) Human Fertility. Methods in Molecular Biology, vol 1154. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-0659-8_13

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  • DOI: https://doi.org/10.1007/978-1-4939-0659-8_13

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  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4939-0658-1

  • Online ISBN: 978-1-4939-0659-8

  • eBook Packages: Springer Protocols

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