■这项研究比较了,在接受IVF治疗的高反应者中,GnRH激动剂单触发和双触发对卵母细胞提取率和累积活产率(LBR)的影响。目的是确定仅GnRH激动剂触发是否提供了与双重触发相当的结果。同时将卵巢过度刺激综合征(OHSS)的风险降至最低。
■回顾,配对病例对照研究在台中退伍军人总医院进行,台湾,包括2014年1月1日至2022年12月31日期间接受IVF/ICSI的女性.纳入标准为:GnRH拮抗剂方案和触发日雌激素水平>3,000pg/ml。排除标准为:免疫/代谢性疾病,捐赠的卵母细胞,和混合刺激周期。倾向得分匹配应用于平衡年龄,AMH水平,仅GnRH激动剂组和双重触发组之间的卵母细胞数量。分析了具有完整治疗周期的患者的结果,重点关注卵母细胞提取率和累积LBR。
■我们分析了仅激动剂组的116个周期,和双触发组中的232个周期。他们的年龄没有发现组间差异,BMI,AMH水平。双触发组有更高的取卵率(93%vs.80%;p<0.05),而受精率,囊胚形成率,和累积LBR具有可比性。值得注意的是,仅GnRH激动剂组未报告OHSS病例,双触发组7例。
■与双重触发相比,仅GnRH激动剂触发导致较低的卵母细胞回收率,但对高反应者的累积LBR没有显着影响。这种方法在不影响妊娠结局的情况下有效降低了OHSS风险。使其成为冻结所有策略中的首选,尽管卵母细胞拾取时间较长,成本中等。仅GnRH激动剂触发剂,然而,可能不适合新鲜胚胎移植或触发日血清LH水平低的患者。
UNASSIGNED: This study compared, in high responders undergoing IVF treatment, GnRH agonist-only trigger and dual trigger on oocyte retrieval rate and cumulative live birth rate (LBR). The aim was to determine if the GnRH agonist-only triggers had provided outcomes comparable to dual trigger, while minimizing the risk of ovarian hyperstimulation syndrome (OHSS).
UNASSIGNED: A retrospective, matched case-control study was conducted at Taichung Veterans General Hospital, Taiwan, including women who underwent IVF/ICSI between January 1, 2014, and December 31, 2022. Inclusion criteria were: GnRH antagonist protocol and estrogen level >3,000 pg/ml on trigger day. Exclusion criteria were: immune/metabolic diseases, donated oocytes, and mixed stimulation cycles. Propensity score matching was applied to balance age, AMH level, and oocyte number between the GnRH agonist-only and dual trigger groups. Outcomes were analyzed for patients who had complete treatment cycles, focusing on oocyte retrieval rate and cumulative LBR.
UNASSIGNED: We analyzed 116 cycles in the agonist-only group, and 232 cycles in the dual trigger group. No inter-group difference was found in their age, BMI, and AMH levels. The dual trigger group had a higher oocyte retrieval rate (93% vs. 80%; p <0.05), while fertilization rates, blastocyst formation rates, and cumulative LBR were comparable. Notably, no OHSS cases had been reported in the GnRH agonist-only group, compared with 7 cases in the dual trigger group.
UNASSIGNED: GnRH agonist-only triggers resulted in a lower oocyte retrieval rate compared to dual triggers but did not significantly affect cumulative LBR in high responders. This approach effectively reduces OHSS risk without compromising pregnancy outcomes, making it a preferable option in freeze-all strategies, despite a longer oocyte pick-up duration and a medium cost. GnRH agonist-only trigger, however, may not be suitable for fresh embryo transfers or patients with low serum LH levels on trigger day.