Is oocyte maturity influenced by ovulation trigger type in oocyte donation cycles?

Area of Science:

• Reproductive Endocrinology
• Infertility Treatment
• Oocyte Donation

Background:

• Oocyte donation cycles require careful selection of ovulation induction protocols.
• Different trigger medications, including GnRHa, dual trigger (GnRHa + hCG), and hCG alone, are used to mature oocytes.
• Optimizing oocyte yield while minimizing risks like OHSS is crucial.

Purpose of the Study:

• To compare clinical and laboratory outcomes of GnRHa, dual trigger, and hCG trigger methods in altruistic oocyte donation.
• To evaluate the efficacy and safety of different ovulation trigger strategies.

Main Methods:

• Retrospective analysis of 333 altruistic oocyte donation cycles.
• Categorization of donors into normal/high responders and low responders.
• Comparison of outcomes based on trigger type: GnRHa, dual trigger (GnRHa + low-dose hCG), or hCG.

Main Results:

• GnRHa and dual trigger groups yielded significantly more mature oocytes than the hCG group (p < 0.001).
• The dual trigger group had a significantly higher OHSS rate (8.5%) compared to GnRHa (0.4%) and hCG (0%) groups (p = 0.001).
• GnRHa trigger maximized oocyte yield in normal/high responders with reduced OHSS risk compared to dual trigger.

Conclusions:

• GnRHa trigger is recommended for maximizing mature oocyte yield in normal to high responders undergoing oocyte donation, offering a significant reduction in OHSS risk versus dual trigger.
• Dual trigger should be avoided in oocyte donation due to increased OHSS risk.
• HCG trigger is a viable option for carefully selected low-risk donors where GnRHa may be less effective.