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Updated: May 13, 2026

OP-IVM: Combining In vitro Maturation after Oocyte Retrieval with Gynecological Surgery
Published on: May 9, 2021
Failure of GnRH agonist-triggered oocyte maturation: its cause and management
Yoshimasa Asada1, Fumiaki Itoi, Hiroyuki Honnma
1Asada Ladies Clinic, RENAK 5F, Matsushincho 1-4, Kasugai, Aichi, 486-0931, Japan. y_asada@ivf-asada.jp
Objective:
In the present study we investigated the cause of GnRHa's failure to trigger oocyte maturation and present an effective rescue protocol for use when failure occurs.
Design:
Case reports.
Setting:
One in vitro fertilization (IVF) center.
Patient(S):
Eight cases of failure of GnRH agonist (GnRHa)-triggered oocyte maturation and one case of GnRHa successfully triggered oocyte maturation, despite a weak response in the LH-RH test.
Main Outcome Measure(S):
All cases were successfully rescued by re-triggering maturation using HCG, with seven of the eight patients achieving ongoing pregnancy and successful delivery.
Result(S):
In three patients the cause of the oocyte maturation failure was likely temporal or continuous severe down-regulation of the hypothalamus-pituitary-axis, the cause was unknown in the other five patients.
Conclusion(S):
In cases where GnRHa fails to trigger oocyte maturation, a rescue protocol entailing re-triggering with HCG can produce successful outcomes.
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