Abstract
To compare the oocyte maturation rate in the treatment of in vitro fertilization (IVF) in terms of the use of human chorionic gonadotropin (hCG), agonist gonadotropin-releasing hormone (GnRH) and dual trigger and to evaluate the associated risk factors for sub-optimal maturation rates. A retrospective cohort study with 856 women who underwent IVF. They performed oocyte retrieval and were classified into 3 groups (1 - hCG, 2 - GnRH agonist, 3 - dual trigger). The primary outcome was maturation rate per trigger, and the secondary outcomes were the pregnancy rate per oocyte retrieval and the correlations between low maturation rate as well as the clinical and treatment characteristics of women. The maturation rate was 77% in group 1; 76% in group 2, and 83% in group 3 (p = 0.003). Group 2 showed women with better ovarian reserve, greater number of oocytes collected, and more mature oocytes and embryos compared with the other groups (p < 0.001). The cumulative clinical pregnancy rate was no different between the groups (p = 0.755). Low ovarian reserve and low doses of follicle-stimulating hormone (FSH) administered during the stimulus were associated with a higher chance of null maturation rate. The oocyte maturation rates and IVF results were similar in all groups. Low ovarian reserve is associated with the worst treatment results.
Highlights
Favorable in vitro fertilization (IVF) results are related to satisfying results after ovarian stimulation, lower rates of ovarian hyperstimulation syndrome (OHSS), and lower rates of multiple pregnancies.[1]
O desfecho primário foi a taxa de maturação por gatilho, e os desfechos secundários foram a taxa de gravidez por recuperação de oócitos e as correlações entre a baixa taxa de maturação bem como as características clínicas e do tratamento das mulheres
Conclusão As taxas de maturação oocitárias e os resultados de fertilização in vitro (FIV) foram semelhantes em todos os grupos
Summary
Favorable in vitro fertilization (IVF) results are related to satisfying results after ovarian stimulation, lower rates of ovarian hyperstimulation syndrome (OHSS), and lower rates of multiple pregnancies.[1] The number of mature eggs captured in in vitro fertilization is directly related to the chances of pregnancy.[2] The number of mature eggs and the risk of OHSS are directly related to the choice of the trigger. The most commonly used ovulation trigger is human chorionic gonadotropin (hCG).[3] the use of hCG can increase the riskof OHSS. A safer way to perform oocyte maturation is by using the gonadotropin-releasing hormone (GnRH) agonist, because it can reduce severe forms of OHSS by 50%; it requires intense luteal phase support.[4,5]
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