Objectives: The aim of the study was to compare the efficacy and safety of GnRH-agonist to the human chorionic gonadotrophin (HCG) trigger in cases of simple ovarian stimulation.</span></span><span>&...Objectives: The aim of the study was to compare the efficacy and safety of GnRH-agonist to the human chorionic gonadotrophin (HCG) trigger in cases of simple ovarian stimulation.</span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Study design: Randomized controlled trial was conducted on 291 women complaining of unexplained infertility visiting Elshatby Maternity University Hospital from February to December 2019. Trial registration unique ID</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> is</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> PACTR202001787868341 (</span></span></span><a href="https://www.pactr.org/"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">https://www.pactr.org/</span></span></span></a><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">). Age included from 20</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">- 43 years. All patients were stimulated by the sequential stimulation protocol using letrozole then FSH injection, when the criteria of ovulation trigger were reached</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">;</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> cases were randomized into two groups using closed envelopes method</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Group A (123 cases) GnRh agonist (triptorelin 0.2 IU) subcutaneous injection and Group B (168 cases) HCG 10,000 IU intramuscular injection w</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ere</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> used for triggering of ovulation then followed by timed intercourse.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Results: Primary outcome was the clinical pregnancy rate while rate of miscarriage and ovarian hyper-stimulation rate were the secondary outcome. Clinical pregnancy rates, in Group A w</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ere</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> (21.1%) while it was (31.5%) in another group (P</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">=</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">0.049). Miscarriage rate was (4.9%) in the first group and (3.6%) in the second group (P</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">=</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">0.580). Except for one case of moderate ovarian hyper-stimulation syndrome (OHSS) complicated the HCG group, there were no such cases in GnRH group.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Conclusion: Triggering final oocyte maturation with HCG was superior to GnRH agonists triggers as regards the clinical pregnancy rate.展开更多
Objective To describe two clinical cases involving patients who were administered 800 IU of hCG to trigger oocyte maturation and who underwent a frozen-thawed embryo transfer （FET） cycle. Methods Two infertile patie...Objective To describe two clinical cases involving patients who were administered 800 IU of hCG to trigger oocyte maturation and who underwent a frozen-thawed embryo transfer （FET） cycle. Methods Two infertile patients with high ovarian response undergoing stimulation for IVF,, in which 800 IU of hCG was injected by mistake. IVF patients treated under a short protocol with 800 IU of hCG triggering ovulation. Live birth, clinical pregnancy outcomes and ovarian hyperstimulation syndrome （OHSS） were observed. Results Neither cycle of the two patients was canceled for oocyte retrieval failure and no OHSS was observed. Both patients gave birth to live twins after FET. Conclusion Triggering oocyte maturation in two hyper-responders by employing 800 IU of hCG could produce a good quantity of good-quality oocytes and an excellent clinical pregnancy and retain the opportunity for conception and live birth. Broader studies are needed.展开更多
BACKGROUND Borderline form of empty follicle syndrome is a condition in which only a few mature or immature oocytes are recovered after meticulous follicular aspiration,despite adequate ovarian response to stimulation...BACKGROUND Borderline form of empty follicle syndrome is a condition in which only a few mature or immature oocytes are recovered after meticulous follicular aspiration,despite adequate ovarian response to stimulation.It is a rare phenomenon with an unclear cause.Currently,the condition still lacks effective treatment.CASE SUMMARY A patient with secondary infertility who had undergone three cycles of assisted reproductive technique(ART)is described.With regard to good follicular response,two oocytes were obtained in the first two ART cycles,but no embryo was formed.In the third ART cycle,which is the subject of this study,ovulation was induced by dual trigger of a supernormal dose of human chorionic gonadotropin(HCG)combined with a delayed oocyte retrieval approach.The method involved administration of gonadotropin-releasing hormone agonist,recombinant HCG,and urinary HCG 39 h before ovum pick-up.Ten oocytes were recovered,two out of three mature eggs were fertilized after intracytoplasmic sperm injection,resulting in two embryos that were subsequently cryopreserved.The case report guidelines have been used herein to present the first case of this novel dual trigger method.CONCLUSION This approach provides a new treatment option for patients with a similar condition in the future.This study can also inspire further investigation on the effects of variousβ-HCG serum levels 36 h after intramuscular HCG administration.展开更多
文摘Objectives: The aim of the study was to compare the efficacy and safety of GnRH-agonist to the human chorionic gonadotrophin (HCG) trigger in cases of simple ovarian stimulation.</span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Study design: Randomized controlled trial was conducted on 291 women complaining of unexplained infertility visiting Elshatby Maternity University Hospital from February to December 2019. Trial registration unique ID</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> is</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> PACTR202001787868341 (</span></span></span><a href="https://www.pactr.org/"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">https://www.pactr.org/</span></span></span></a><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">). Age included from 20</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">- 43 years. All patients were stimulated by the sequential stimulation protocol using letrozole then FSH injection, when the criteria of ovulation trigger were reached</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">;</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> cases were randomized into two groups using closed envelopes method</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Group A (123 cases) GnRh agonist (triptorelin 0.2 IU) subcutaneous injection and Group B (168 cases) HCG 10,000 IU intramuscular injection w</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ere</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> used for triggering of ovulation then followed by timed intercourse.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Results: Primary outcome was the clinical pregnancy rate while rate of miscarriage and ovarian hyper-stimulation rate were the secondary outcome. Clinical pregnancy rates, in Group A w</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ere</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> (21.1%) while it was (31.5%) in another group (P</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">=</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">0.049). Miscarriage rate was (4.9%) in the first group and (3.6%) in the second group (P</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">=</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">0.580). Except for one case of moderate ovarian hyper-stimulation syndrome (OHSS) complicated the HCG group, there were no such cases in GnRH group.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Conclusion: Triggering final oocyte maturation with HCG was superior to GnRH agonists triggers as regards the clinical pregnancy rate.
文摘Objective To describe two clinical cases involving patients who were administered 800 IU of hCG to trigger oocyte maturation and who underwent a frozen-thawed embryo transfer （FET） cycle. Methods Two infertile patients with high ovarian response undergoing stimulation for IVF,, in which 800 IU of hCG was injected by mistake. IVF patients treated under a short protocol with 800 IU of hCG triggering ovulation. Live birth, clinical pregnancy outcomes and ovarian hyperstimulation syndrome （OHSS） were observed. Results Neither cycle of the two patients was canceled for oocyte retrieval failure and no OHSS was observed. Both patients gave birth to live twins after FET. Conclusion Triggering oocyte maturation in two hyper-responders by employing 800 IU of hCG could produce a good quantity of good-quality oocytes and an excellent clinical pregnancy and retain the opportunity for conception and live birth. Broader studies are needed.
文摘BACKGROUND Borderline form of empty follicle syndrome is a condition in which only a few mature or immature oocytes are recovered after meticulous follicular aspiration,despite adequate ovarian response to stimulation.It is a rare phenomenon with an unclear cause.Currently,the condition still lacks effective treatment.CASE SUMMARY A patient with secondary infertility who had undergone three cycles of assisted reproductive technique(ART)is described.With regard to good follicular response,two oocytes were obtained in the first two ART cycles,but no embryo was formed.In the third ART cycle,which is the subject of this study,ovulation was induced by dual trigger of a supernormal dose of human chorionic gonadotropin(HCG)combined with a delayed oocyte retrieval approach.The method involved administration of gonadotropin-releasing hormone agonist,recombinant HCG,and urinary HCG 39 h before ovum pick-up.Ten oocytes were recovered,two out of three mature eggs were fertilized after intracytoplasmic sperm injection,resulting in two embryos that were subsequently cryopreserved.The case report guidelines have been used herein to present the first case of this novel dual trigger method.CONCLUSION This approach provides a new treatment option for patients with a similar condition in the future.This study can also inspire further investigation on the effects of variousβ-HCG serum levels 36 h after intramuscular HCG administration.
