In a nutshell
This paper studied the outcome after use of GnRH antagonists and cryopreservation of embryos in women who were at high risk of ovarian hyperstimulation syndrome. Use of GnRH antagonists was effective in achieving high levels of birth rate.
Some background
In-vitro fertilization is a procedure whereby the egg is fertilized by the sperm outside the body. Before this, the ovaries are stimulated with medication to release eggs. These eggs are retrieved and fertilized to become an embryo.
Gonadotrophin-releasing hormone (GnRH) antagonists and agonists are hormone treatments used to stimulate the ovaries. Treatment often begins with a GnRH antagonist, followed by a GnRH agonist to trigger ovulation. This combination may lower the risk of ovarian hyperstimulation syndrome. This syndrome is a serious complication of ovarian stimulation. However, this treatment combination is also associated with lower birth rates. This may be due to other effects of the hormone treatments.
Freezing the embryo (cryopreservation) and waiting for another menstrual cycle may be more effective. The live birth rate following GnRH antagonist therapy, GnRH agonist trigger, and cryopreservation is not known.
Methods & findings
123 women who underwent cryopreservation of embryos were studied. These women were at high risk of developing ovarian hyperstimulation syndrome. All women received GnRH antagonist treatment with GnRH agonists as the final trigger.
There were almost 25 eggs retrieved each cycle. On average, almost 9 embryos were frozen per cycle of egg retrieval.
A total of 65.9% women had a live birth after a maximum of six cycles of embryo transfer. Nineteen twins were born. There were no cases of severe ovarian hyperstimulation syndrome.
The bottom line
The authors concluded that use of GnRH antagonists and agonists and cryopreservation in high risk patients led to good live birth rates.
What’s next?
Talk to your doctor about your risks of ovarian hyperstimulation syndrome and what options there are for ovarian stimulation.
Published By :
Reproductive BioMedicine Online
Date :
Apr 07, 2017
