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• W2220604400 abstract "Ovarian Hyperstimulation (OHSS) is a significant complication of gonadotropin therapy. Ovulation induction cycles should be highly individualized and should use the minimum effective dosage of Human Chorionic Gonadotropin (HCG) to significantly reduce the risk of OHSS. However, it is unclear if pregnancy rates are compromised by Leuprolide Acetate (LA) trigger alone. Oocyte donors with OHSS will frequently have to take time off from work and will refuse to do another Donor Egg/IVF cycle. The use of LA alone has been shown in several studies to trigger ovulation through an endogenous LH surge. This effect is more physiological than an exogenous HCG trigger, thus reducing the risk of pain and OHSS. This is a retrospective study of donor oocyte patients: Leuprolide Acetate (LA) 1 mg (o.2cc) subcutaneously was given synchronously with 1.25 - 5K HCG. Patients were evaluated for OHSS symptoms (pain 1 to 2 days after the oocyte retrieval), number of oocytes retrieved, peak estradiol levels, number of cryopreserved embryos, and implantation rate. Retrospective review of 33 donor oocyte retrievals from 1/2004 - 1/2006 were evaluated in patients who received LA 0.2cc trigger with HCG. These patients were categorized according to if they had pain versus no pain 1 to 2 days after the retrieval. Ages of the egg donors ranged from 20 to 34. Patients were selected to receive HCG plus LA if their estradiol level ranged from 1600-8800 and the number of follicles greater than 15 ranged from 5-12 A total of 33 donor oocyte patients received LA 0.2cc with HCG. There were 8 shared cycles for a total of 39 transfers. Patients who received LA 0.2cc with HCG had estradiol peak levels ranging from 1618 to 8806, total number of oocytes ranging from 13-68, implantation occurred in 29 recipients (16 singletons, 11 twins, and 2 triplets) with cryopreserved embryos ranging form 0-45. There were a total of 7 patients with complaints of mild to moderate pain and 2 OHSS patients. There was a low incidence of pain in the LA plus HCG donors even though their estradiol levels were high and high number of oocytes retrieved. Oocyte donor patients who receive LA with HCG may have a reduced risk of OHSS symptoms, however the amounts of HCG may be the significant factor. It is prudent for all oocyte donor patients to be assessed for OHSS. Lowering HCG dose and/or using LA may decrease the incidenceof OHSS in a donor oocyte program. Oocytes donors may have less morbidity and may be more likely to pursue additional donation cycles if the incidence of OHSS were lower. Larger studies are needed to compare LA with HCG with donor oocyte patients, as well as regular IVF patients. Other factors to consider are evaluating whether it is the effect of the Gonadotropin Releasing Hormone (GnRH) agonist, LA 0.2cc with HCG or is it the lower dosage of HCG that decreases the incidence of OHSS. Also another question to explore would be if lower doses of HCG would be as effective without LA?" @default.
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• W2220604400 date "2006-09-01" @default.
• W2220604400 modified "2023-09-27" @default.
• W2220604400 title "P-129" @default.
• W2220604400 doi "https://doi.org/10.1016/j.fertnstert.2006.07.475" @default.
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