Comparison of reproductive outcomes between trigger with hCG versus GnRH agonist in eggs donors cycle

Abstract

The aim of this study is to compare the controlled ovarian stimulation (COS) protocols and their reproductive outcomes in donors using trigger with human chorionic gonadotropin (hCG) versus GnRH agonist (GnRHa) for In Vitro Fertilization (IVF) cycles of two private centers. Multicenter, Prospective and Comparative Analysis. A total of 66 consecutive cycles of COS in donors from two centers were reviewed. Two groups were formed: Group 1, donors with a luteal phase agonist protocol triggered with 10,000 IU of hCG, and Group 2 with an antagonist protocol using trigger with 0.8 ml of GnRHa (Lucrin Depot®3.75mg). ANOVA test was used for statistical analysis. Both groups were homogeneous for demographic characteristics and stimulation protocols (P=NS): donor age (22.4 ±2.0 vs. 23.7 ±2.2); receptor age (39.1 ±4.9 vs. 42 ±4.2); BMI (23.7 ±3.06 vs. 22.5±2.18); FSH day3 (5.05 ±1.55 vs. 5.95 ±0.97 mIU/ml); LH day3 (3.02 ±1.22 vs. 2.9 ± 1.13 mIU/ml); antral follicles (14.85 ±3.6 vs. 14.83 ±4.9); total doses of rFSH (1700 ±293.8 vs. 1643 ±393.2 IU). During the period of study was reported a single case of OHSS, and one case of ovarian torsion, in group 1. There were no complications in group 2. Reproductive outcomes are described in table 1.Tabled 1Table1. Ovarian stimulation outcomes by group.Group 1 (n=35)Group 2 (n=31)P valueE2 day 10 α2333 ± 147mIU/ml1810 ± 599 mIU/ml0.068Retrieved oocytes α15120.058Oocyte MII α12.510.80.185Embryo transfer α2.82.70.644Embryo transfer G142%54%0.734Gestational sac α1.61.30.662Implantation rate32%26%0.980Pregnancy rate61%54%0.244Ongoing pregnancy rate54%41%0.392α: Mean; G1: grade 1. Open table in a new tab α: Mean; G1: grade 1. Trigger with hCG remains the best option for final oocyte maturation. However, the use of GnRH agonist trigger after GnRH antagonist protocol is equally effective for oocyte maturation, fertilization and pregnancy in donor cycles. In addition it reduces the risk of OHSS and complications of stimulation in high risk patients (donors).