Infertility, Female, In Vitro Fertilization (IVF), Oocytes, Ovulation Induction
Conditions
Keywords
agonist trigger, Ovulation induction, Controlled ovarian stimulation (COS), Poor responder
Brief summary
Agonist triggering in controlled ovarian stimulation protocols is being used during last years (among high responder patients to avoid OHSS). Indeed, agonist triggering is more physiologic than HCG triggering. Investigators propose to compare the effectiveness of both types of trigger among three different subsets of patients: 1. Poor responders. 2. Normo-responders 3. High responders Comparing both the number and the quality of achieved oocytes.
Detailed description
During the last years, ovulation triggering in controlled ovarian stimulation protocols has been used specially to avoid hyperstimulation syndromes (OHSS). Indeed, the substitution of the classical HCG triggering by the agonist one, reduces almost to zero the risk of OHSS. On the other hand poor responder patients to ovarian stimulation represent a challenge in assisted reproduction. Defining poor responders is not easy, but we can define them as those patients with less than 4 eggs obtained after oocyte retrieval. Different strategies have been proposed to overcome this problem. In other words, to obtain more oocytes. These include an increase in FSH doses, an increase in FSH action by adding sensitizers agents. Among the possible strategies, investigators propose the agonist triggering. HCG (classical) triggering represents the use of a LH-like product (with a prolonged action). The administration of a GnRH agonist provoke the production and liberation of both FSH and LH. Thus, the pro-ovulatory action is more physiologic , and possibly, more effective. So, the use of a triggering protocol that nowadays is being used among high responders (thus reducing the OHSS risk) is proposed for both poor responder and normo-responder patients trying to achieve more oocytes, and specifically more mature oocytes.
Interventions
DRUGGonadotropin Releasing Hormone Agonists (GNRH-A)
Administration of a gonadotropin releasing hormone agonist (GnRH-a) (0,2 ml) subcutaneously, 36 hours before ovum pick-up in IVF treatments.
DRUGHuman chorionic gonadotropin
Administration of Human chorionic gonadotropin (HCG) 250 IU subcutaneously , 36 hours before ovum pick-up in IVF treatments.
Sponsors
Ginegorama S.L.
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
IVF patients enrolled either to HCG or agonist trigger ovulation induction
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 48 Years
Healthy volunteers
No
Inclusion criteria
* Women scheduled for IVF treatment. * First ovarian stimulation * Two ovaries present * No previous ovarian surgery * No contraindication for any of the assigned treatments
Exclusion criteria
* Previous ovarian surgery. * Previous IVF treatments. * Absence of one ovary * Presence of an endometrioma
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mature oocytes | Up to 24 weeks | Number of mature oocytes achieved after oocyte retrieval. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Relation mature oocytes/punctured oocytes | Up to 24 weeks | Relation between the number of mature oocytes and the follicles. |
| Fertilized oocytes | Up to 24 weeks | Number of fertilized oocytes |
| Relation fertilized oocytes/achieved Mature oocytes | Up to 24 weeks | Relation between the number of fertilized oocytes and the mature oocytes achieved. |
| Number of blastocysts developed | Up to 24 weeks | Number of blastocysts developed in each arm of the study. |
| Cancelled cycles | Up to 24 weeks | Percentage of cancelled cycles |
Countries
Spain
Contacts
Primary ContactGorka Barrenetxea, PhD
Backup ContactAmaia Garcia, PhD
Outcome results
None listed