Feasibility of corifollitropin alfa/GnRH antagonist protocol combined with GnRH agonist triggering and freeze-all strategy in polycystic ovary syndrome patients
Journal
Journal of the Formosan Medical Association
Journal Volume
117
Journal Issue
6
Pages
535-540
Date Issued
2018
Author(s)
Abstract
Background/Purpose: The long-acting corifollitropin alfa is comparable to FSH in terms of pregnancy outcomes in normal responders and poor responders. Corifollitropin alfa has never been studied in polycystic ovary syndrome (PCOS) patients because of concerns of excessive ovarian stimulation and ovarian hyperstimulation syndrome (OHSS). The purpose of the study was to evaluate if corifollitropin alfa can be used in PCOS patients. Methods: Forty PCOS patients who were going to undergo in vitro fertilization were enrolled in this study. A single injection of corifollitropin alfa was administered on cycle day 2 or day 3. From stimulation day 8 onwards, daily FSH was administered until the day of final oocyte maturation. Cetrorelix was administered from stimulation day 5 to prevent premature LH surge. Final oocyte maturation was triggered by: acetate. All embryos were cryopreserved and replaced in subsequent cycles. Results: All 40 patients were subjected to oocyte retrieval, and none developed moderate or severe ovarian hyperstimulation syndrome (0%, 95% CI 0–0.088). For each patient, an average of 23.4 (±7.4; 95% CI 21.0–25.7) oocytes were retrieved and a mean of 11.7 (±6.4; 95% CI 9.6–13.8) embryos were frozen. Mean serum estradiol level on the day of GnRHa triggering was 7829.9 pg/ml (±3297; 95% CI 6775–8885). The cumulated ongoing pregnancy rate after 3 frozen-thawed embryo transfers was 75.0% (95% CI 61.6%–88.4%). Conclusion: The results suggest that corifollitropin alfa/GnRH antagonist protocol can be used in PCOS patients, in combination with GnRHa triggering and embryo cryopreservation. ? 2017
Other Subjects
acetic acid; alanine aminotransferase; aspartate aminotransferase; cabergoline; cetrorelix; conjugated estrogen; corifollitropin alfa; creatinine; estradiol; follitropin; gonadorelin agonist; gonadorelin antagonist; leuprorelin; nitrogen; progesterone; recombinant follitropin; cetrorelix; follicle stimulating hormone, human, with HCG C-terminal peptide; follitropin; gonadorelin; adult; Article; clinical article; clinical evaluation; clinical protocol; cryopreservation; disease association; estradiol blood level; female; freeze thawing; frozen section; human; in vitro fertilization; luteinizing hormone release; observational study; oocyte maturation; oocyte retrieval; ovary hyperstimulation; ovary polycystic disease; pregnancy rate; prematurity; risk assessment; risk factor; analogs and derivatives; blood; drug effect; embryo transfer; female infertility; oocyte; ovary polycystic disease; ovulation induction; pregnancy; procedures; proof of concept; prospective study; statistics and numerical data; Adult; Cryopreservation; Embryo Transfer; Female; Fertilization in Vitro; Follicle Stimulating Hormone, Human; Gonadotropin-Releasing Hormone; Humans; Infertility, Female; Oocyte Retrieval; Oocytes; Ovarian Hyperstimulation Syndrome; Ovulation Induction; Polycystic Ovary Syndrome; Pregnancy; Pregnancy Rate; Proof of Concept Study; Prospective Studies
Type
journal article