Elsevier

Fertility and Sterility

Volume 100, Issue 3, September 2013, Pages 742-747.e1
Fertility and Sterility

Original article
Early luteal phase endocrine profile is affected by the mode of triggering final oocyte maturation and the luteal phase support used in recombinant follicle-stimulating hormone–gonadotropin-releasing hormone antagonist in vitro fertilization cycles

https://doi.org/10.1016/j.fertnstert.2013.05.028Get rights and content
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Objective

To assess endocrine differences during early luteal phase according to mode of triggering final oocyte maturation with or without luteal phase support (LPS).

Design

A prospective randomized study.

Setting

University center for reproductive medicine.

Patient(s)

Four oocyte donors each underwent four consecutive cycles.

Intervention(s)

To avoid interpatient variation, each donor underwent the same stimulation regimen. However, different modes of triggering final oocyte maturation and LPS were administered: A) 10,000 IU hCG and standard LPS; B) GnRH agonist (GnRHa; 0.2 mg triptorelin), and 35 hours later 1,500 IU hCG, and standard LPS; C) GnRH agonist (0.2 mg triptorelin) and standard LPS; and D) GnRH agonist (0.2 mg triptorelin) without LPS.

Main Outcome Measure(s)

Blood sampling was performed on the day of ovulation trigger, ovulation trigger + 1 day, and ovum pick-up + 5 days. Serum E2, FSH, LH, and P were measured.

Result(s)

The early luteal phase steroid levels following GnRHa trigger and modified luteal phase support (B) were similar to those seen after hCG trigger (A). However, significant differences were seen between groups A and B compared with C and D, as well as between groups C and D.

Conclusion(s)

Administration of a single bolus of GnRHa effectively induced LH and FSH surges in oocyte donors stimulated with recombinant FSH and cotreated with a GnRH antagonist. However, gonadotropin and steroid levels differed significantly according to the type of luteal phase support used after GnRHa trigger.

European Community Clinical Trial System (EudraCT) Number

2009-009429-26.

Key Words

Progesterone
luteal phase
GnRH antagonist
GnRH agonist trigger
hCG

Cited by (0)

H.M.F. has received honoraria as a speaker for Ferring, Merck Serono, Merck, Sharp & Dohme (MSD), IBSA, and Actavis; served as an advisory board member for MSD, received travel grants from Merck Serono, Ferring; and MSD and grants from MSD. N.P.P. has nothing to disclose. I.v.V. received a travel grant from MSD Belgium to present a part of this work at ESHRE, Istanbul, 2012. C.B. has nothing to disclose. C.B. has nothing to disclose. B.A. has nothing to disclose. E.G.P. has received payment for lectures from MSD and Merck Serono. P.H. has received a lecture honorarium from Merck Serono, MSD Denmark, and Nordic Infucare.

Supported by Merck, Sharp & Dohme/Belgium, a subsidiary of Merck & Co.