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Individual luteolysis pattern after GnRH-agonist trigger for final oocyte maturation.

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Area of Science:

  • Reproductive Endocrinology
  • Infertility Treatment
  • Assisted Reproductive Technology

Background:

  • GnRH-agonist trigger for final oocyte maturation in GnRH-antagonist protocols is widely adopted to prevent ovarian hyperstimulation syndrome (OHSS).
  • However, this strategy may compromise pregnancy rates due to significant luteolysis (luteal phase defect).

Purpose of the Study:

  • To evaluate the extent of luteolysis following GnRH-agonist trigger in a GnRH-antagonist protocol.
  • To identify factors influencing luteolysis and inform personalized luteal phase support.

Main Methods:

  • A proof-of-concept study involving 51 patients undergoing IVF with GnRH-antagonist protocol and GnRH-agonist trigger.
  • Progesterone levels were measured 48 hours post-oocyte retrieval to assess luteolysis.
  • Correlation analysis was performed to identify factors associated with progesterone levels.

Main Results:

  • Progesterone levels 48 hours post-retrieval exhibited wide inter-patient variability (13.0 ng/ml to ≥ 60.0 ng/ml).
  • Significant positive correlations were observed between post-retrieval progesterone levels and duration of stimulation/suppression, total suppression medication, pre-trigger progesterone, and oocyte yield.
  • Luteolysis following GnRH-agonist trigger is patient-specific.

Conclusions:

  • The degree of luteolysis after GnRH-agonist trigger is highly individualized.
  • Luteal phase support requires personalization, considering factors like stimulation duration, pre-trigger progesterone levels, and oocyte retrieval numbers.
  • Optimizing luteal phase support may improve pregnancy rates in this patient population.