Suboptimal response to GnRH agonist trigger: causes and practical management.
Journal
Current opinion in obstetrics & gynecology
ISSN: 1473-656X
Titre abrégé: Curr Opin Obstet Gynecol
Pays: England
ID NLM: 9007264
Informations de publication
Date de publication:
01 06 2021
01 06 2021
Historique:
entrez:
26
4
2021
pubmed:
27
4
2021
medline:
16
10
2021
Statut:
ppublish
Résumé
GnRH agonist products are used extensively worldwide to trigger ovulation and final oocyte maturation in in vitro fertilization cycles. The purpose of this article is to outline possible causes for a suboptimal response to the GnRH agonist trigger. Risk factors for such a suboptimal response include prolonged hormonal contraceptive use, previous GnRHa-induced pituitary downregulation, a hypogonadotropic/hypogonadal condition, patient error, environmental conditions that may damage the GnRHa product used, GnRH and luteinizing hormone (LH) receptors polymorphisms, low baseline LH and low endogenous serum LH levels on trigger day as well as low BMI. The induction of an adequate LH surge can be ascertained by an LH urine test 12 h post trigger. In most cases, GnRHa trigger elicits effective LH+follicle stimulating hormone surges, resulting in mature, fertilizable oocytes. Clinical awareness to conditions that may predispose to a suboptimal response to the GnRHa trigger may prevent failed oocyte retrial.
Identifiants
pubmed: 33896918
doi: 10.1097/GCO.0000000000000701
pii: 00001703-202106000-00012
doi:
Substances chimiques
Chorionic Gonadotropin
0
Fertility Agents, Female
0
Gonadotropin-Releasing Hormone
33515-09-2
Luteinizing Hormone
9002-67-9
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
213-217Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Références
de Herder WW. Heroes in endocrinology: Nobel Prizes. Endocr Connect 2014; 3:R94–R104.
Healy D, Rogers PA, MacLachlan RI. Management of unsatisfactory superovulation responses in an IVF programme. Hum Reprod 1986; 1:20–26.
Fleming R, Adam AH, Barlow DH, et al. A new systematic treatment for infertile women with abnormal hormone profiles. Br J Obstet Gynaecol 1982; 89:80–83.
Itskovitz J, Boldes R, Barlev A, et al. The induction of LH surge and oocyte maturation by GnRH analogue (Buserelin) in women undergoing ovarian stimulation for in vitro fertilization. Gynecol Endocrinol 1988; 2: (Suppl 1): 165.
Itskovitz J, Boldes R, Levron J, et al. Induction of preovulatory luteinizing hormone surge and prevention of ovarian hyperstimulation syndrome by gonadotropin-releasing hormone agonist. Fertil Steril 1991; 56:213–220.
Albano C, Smitz J, Camus M, et al. Comparison of different doses of gonadotropin-releasing hormone antagonist Cetrorelix during controlled ovarian hyperstimulation. Fertil Steril 1997; 67:917–922.
Itskovitz-Eldor J, Kol S, Mannaerts B, Coelingh Bennink H. Case report: first established pregnancy after controlled ovarian hyperstimulation with recombinant follicle stimulating hormone and gonadotrophin-releasing hormone antagonist ganirelix (Org 37462). Hum Reprod 1998; 13:295–1295.
Borm G, Mannaerts B. European Orgalutran Study Group. Treatment with the gonadotropin-releasing hormone antagonist ganirelix in women undergoing controlled ovarian hyperstimulation with recombinant follicle stimulating hormone is effective, safe and convenient. Hum Reprod 2000; 49:118–122.
Fauser BC, de Jong D, Olivennes F, et al. Endocrine profiles after triggering of final oocyte maturation with GnRH agonist after cotreatment with the GnRH antagonist ganirelix during ovarian hyperstimulation for in vitro fertilization. J Clin Endocrinol Metab 2002; 87:709–715.
Lewit N, Kol S, Manor D, Itskovitz-Eldor J. 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 1996; 11:1399–1402.
Bar-Hava I, Mizrachi Y, Karfunkel-Doron D, et al. Intranasal gonadotropin-releasing hormone agonist (GnRHa) for luteal-phase support following GnRHa triggering, a novel approach to avoid ovarian hyperstimulation syndrome in high responders. Fertil Steril 2016; 106:330–333.
Bar Hava I, Yafee H, Omer Y, et al. GnRHa for trigger and luteal phase support in natural cycle frozen embryo transfer: a proof of concept study. Reprod Biol 2020; 20:282–287.
Vuong TN, Ho MT, Ha TD, et al. Gonadotropin-releasing hormone agonist trigger in oocyte donors co-treated with a gonadotropin-releasing hormone antagonist: a dose-finding study. Fertil Steril 2016; 105:356–363.
Pirard C, Donnez J, Loumaye E. GnRH agonist as luteal phase support in assisted reproduction technique cycles: results of a pilot study. Hum Reprod 2006; 21:1894–1900.
Humaidan P, Bredkjaer HE, Bungum L, et al. GnRH agonist (buserelin) or hCG for ovulation induction in GnRH antagonist IVF/ICSI cycles: a prospective randomized study. Hum Reprod 2005; 20:1213–1220.
Humaidan P, Bungum L, Bungum M, Yding Andersen C. Rescue of corpus luteum function with peri-ovulatory HCG supplementation in IVF/ICSI GnRH antagonist cycles in which ovulation was triggered with a GnRH agonist: a pilot study. Reprod Biomed Online 2006; 13:173–178.
Humaidan P, Ejdrup Bredkjaer H, Westergaard LG, Yding Andersen C. 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 2010; 93:847–854.
Humaidan P, Polyzos NP, Alsbjerg B, et al. GnRHa trigger and individualized luteal phase hCG support according to ovarian response to stimulation: two prospective randomized controlled multicentre studies in IVF patients. Hum Reprod 2013; 28:2511–2521.
Borgbo T, Povlsen BB, Andersen CY, et al. Comparison of gene expression profiles in granulosa and cumulus cells after ovulation induction with either human chorionic gonadotropin or a gonadotropin-releasing hormone agonist trigger. Fertil Steril 2013; 100:994–1001.
Seyhan A, Ata B, Polat M, et al. Severe early ovarian hyperstimulation syndrome following GnRH agonist trigger with the addition of 1500 IU hCG. Hum Reprod 2013; 28:2522–2528.
Engmann L, DiLuigi A, Schmidt D, et al. 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 2008; 89:84–91.
Castillo JC, Dolz M, Bienvenido E, et al. Cycles triggered with GnRH agonist: exploring low-dose HCG for luteal support. Reprod Biomed Online 2010; 20:175–181.
Parneix I, Emperaire JC, Ruffie A, Parneix P. Comparison of different protocols of ovulation induction, by GnRH agonists and chorionic gonadotropin [in French]. Gynecol Obstet Fertil 2001; 29:100–105.
Pirard C, Loumaye E, Laurent P, Wyns C. Contribution to more patient-friendly ART treatment: efficacy of continuous low-dose GnRH agonist as the only luteal support: results of a prospective, randomized, comparative study. Int J Endocrinol 2015; 2015:727569.
Castillo JC, Garcia-Velasco J, Humaidan P. Empty follicle syndrome after GnRHa triggering versus hCG triggering in COS. J Assist Reprod Genet 2012; 29:249–253.
Beranova M, Oliveira LM, Bédécarrats GY, et al. Prevalence, phenotypic spectrum, and modes of inheritance of gonadotropin-releasing hormone receptor mutations in idiopathic hypogonadotropic hypogonadism. J Clin Endocrinol Metab 2001; 86:1580–1588.
Perez Mayorga M, Gromoll J, Behre HM, et al. Ovarian response to follicle-stimulating hormone (FSH) stimulation depends on the FSH receptor genotype. J Clin Endocrinol Metab 2000; 85:3365–3369.
Piersma D, Verhoef-Post M, Berns EM, Themmen AP. LH receptor gene mutations and polymorphisms: an overview. Mol Cell Endocrinol 2007; 260-262:282–286.
Alviggi C, Clarizia R, Pettersson K, et al. Suboptimal response to GnRHa long protocol is associated with a common LH polymorphism. Reprod Biomed Online 2011; 22: (Suppl 1): S67–72.
Stevenson TL, Lashen H. Empty follicle syndrome: the reality of a controversial syndrome, a systematic review. Fertil Steril 2008; 90:691–698.
Griesinger G, Schultz L, Bauer T, et al. 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 2011; 95:2029–2033.
Honnma H, Hashiba Y, Asada Y, Endo T. Failure of triggering oocyte maturation with a GnRH agonist in polycystic ovary syndrome: two case reports. Eur J Obstet Gynecol Reprod Biol 2011; 157:239–240.
Lok F, Pritchard J, Lashen H. Successful treatment of empty follicle syndrome by triggering endogenous LH surge using GnRH agonist in an antagonist down-regulated IVF cycle. Hum Reprod 2003; 18:2079–2081.
Castillo JC, Haahr T, Martínez-Moya M, Humaidan P. Gonadotropin-releasing hormone agonist ovulation trigger-beyond OHSS prevention. Ups J Med Sci 2020; 125:138–143.
Chen SL, Ye DS, Chen X, et al. Circulating luteinizing hormone level after triggering oocyte maturation with GnRH agonist may predict oocyte yield in flexible GnRH antagonist protocol. Hum Reprod 2012; 27:1351–1356.
Meyer L, Murphy LA, Gumer A, et al. Risk factors for a suboptimal response to gonadotropin-releasing hormone agonist trigger during in vitro fertilization cycles. Fertil Steril 2015; 104:637–642.
Chang FE, Beall SA, Cox JM, et al. Assessing the adequacy of gonadotropin-releasing hormone agonist leuprolide to trigger oocyte maturation and management of inadequate response. Fertil Steril 2016; 106:1093–1100.
Popovic-Todorovic B, Santos-Ribeiro S, Drakopoulos P, et al. Predicting suboptimal oocyte yield following GnRH agonist trigger by measuring serum LH at the start of ovarian stimulation. Hum Reprod 2019; 34:2027–2035.
Horowitz E, Mizrachi Y, Farhi J, et al. Does the interval between the last GnRH antagonist dose and the GnRH agonist trigger affect oocyte recovery and maturation rates? Reprod Biomed Online 2020; 41:917–924.
Barrière P, Avril C, Benmahmoud-Zoubir A, et al. Patient perceptions and understanding of treatment instructions for ovarian stimulation during infertility treatment. Reprod Biomed Soc Online 2019; 9:37–47.
Demirbilek H, Alikasifoglu A, Gonc NE, et al. Assessment of gonadotrophin suppression in girls treated with GnRH analogue for central precocious puberty; validity of single luteinizing hormone measurement after leuprolide acetate injection. Clin Endocrinol (Oxf) 2012; 76:126–130.
Humaidan P, Kol S, Papanikolaou EG. on behalf of the ‘The Copenhagen GnRH Agonist Triggering Workshop Group’. GnRH agonist for triggering of final oocyte maturation: time for a change of practice? Hum Reprod Update 2011; 17:510–524.
Kummer NE, Feinn RS, Griffin DW, et al. Predicting successful induction of oocyte maturation after gonadotropin-releasing hormone agonist (GnRHa) trigger. Hum Reprod 2013; 28:152–159.
Cozzolino M, Matey S, Alvarez A, et al. Self-detection of the LH surge in urine after GnRH agonist trigger in IVF: how to minimize failure to retrieve oocytes. Front Endocrinol (Lausanne) 2020; 21:221.