A novel strategy of using corifollitropin alfa in the ultrashort gonadotropin-releasing hormone agonist (GnRHa) protocol in unselected patients: A patient-friendly alternative

Tzu Ning Yu, Yung Liang Liu, Peng Hui Wang, Chi Huang Chen, Ching Hui Chen, Chii Ruey Tzeng

Research output: Contribution to journalArticle

Abstract

Objective: To compare the outcomes of in vitro fertilization (IVF) and fresh embryo transfer (ET) using corifollitropin alfa in ultrashort gonadotropin-releasing hormone agonist (GnRHa) protocol and GnRH antagonist protocol. Materials and methods: A total of 245 unselected patients undergoing IVF/fresh ET were enrolled between January 1 and December 31, 2017, including 135 treated with ultrashort GnRHa protocol and 110 treated with antagonist protocol. The primary outcomes were number of total injections and outpatient department (OPD) visits before ovulation triggering. The secondary outcomes were the duration of stimulation, dosage of additional gonadotropin for ovarian hyperstimulation, rates of pregnancy, clinical pregnancy, live birth, ovarian response, and ovarian hyperstimulation syndrome (OHSS) rate. Results: Patients treated with ultrashort GnRHa required less additional gonadotropin, fewer total injections, but had better ovarian responses, including more oocytes retrieved, more metaphase II oocytes, and more blastocysts than those treated with antagonist did. A premature LH surge occurred only in six patients treated with antagonist protocol. The rates of pregnancy (37.0% vs. 43.6%), clinical pregnancy (25.2% vs. 34.6%), and live birth (19.3% vs. 30.0%) did not differ significantly between the two groups. The OHSS rate was similar in the two groups. Conclusion: In unselected patients using corifollitropin alfa, the ultrashort GnRHa protocol needed lower dose of additional gonadotropin and fewer injections but produced similar pregnancy outcomes than antagonist protocol did, suggesting that the ultrashort GnRHa protocol could be an alternative.

Original languageEnglish
Pages (from-to)656-661
Number of pages6
JournalTaiwanese Journal of Obstetrics and Gynecology
Volume58
Issue number5
DOIs
Publication statusPublished - Sep 1 2019

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Gonadotropin-Releasing Hormone
Gonadotropins
Ovarian Hyperstimulation Syndrome
Embryo Transfer
Live Birth
Pregnancy Rate
Fertilization in Vitro
Injections
Oocytes
Pregnancy
Blastocyst
Pregnancy Outcome
Metaphase
Ovulation
follicle stimulating hormone, human, with HCG C-terminal peptide
Outpatients

Keywords

  • Antagonist protocol
  • Corifollitropin alfa
  • Fresh embryo transfer
  • In vitro fertilization
  • Ultrashort GnRHa protocol

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

@article{00df3397b0264678bf66cce294296e8c,
title = "A novel strategy of using corifollitropin alfa in the ultrashort gonadotropin-releasing hormone agonist (GnRHa) protocol in unselected patients: A patient-friendly alternative",
abstract = "Objective: To compare the outcomes of in vitro fertilization (IVF) and fresh embryo transfer (ET) using corifollitropin alfa in ultrashort gonadotropin-releasing hormone agonist (GnRHa) protocol and GnRH antagonist protocol. Materials and methods: A total of 245 unselected patients undergoing IVF/fresh ET were enrolled between January 1 and December 31, 2017, including 135 treated with ultrashort GnRHa protocol and 110 treated with antagonist protocol. The primary outcomes were number of total injections and outpatient department (OPD) visits before ovulation triggering. The secondary outcomes were the duration of stimulation, dosage of additional gonadotropin for ovarian hyperstimulation, rates of pregnancy, clinical pregnancy, live birth, ovarian response, and ovarian hyperstimulation syndrome (OHSS) rate. Results: Patients treated with ultrashort GnRHa required less additional gonadotropin, fewer total injections, but had better ovarian responses, including more oocytes retrieved, more metaphase II oocytes, and more blastocysts than those treated with antagonist did. A premature LH surge occurred only in six patients treated with antagonist protocol. The rates of pregnancy (37.0{\%} vs. 43.6{\%}), clinical pregnancy (25.2{\%} vs. 34.6{\%}), and live birth (19.3{\%} vs. 30.0{\%}) did not differ significantly between the two groups. The OHSS rate was similar in the two groups. Conclusion: In unselected patients using corifollitropin alfa, the ultrashort GnRHa protocol needed lower dose of additional gonadotropin and fewer injections but produced similar pregnancy outcomes than antagonist protocol did, suggesting that the ultrashort GnRHa protocol could be an alternative.",
keywords = "Antagonist protocol, Corifollitropin alfa, Fresh embryo transfer, In vitro fertilization, Ultrashort GnRHa protocol",
author = "Yu, {Tzu Ning} and Liu, {Yung Liang} and Wang, {Peng Hui} and Chen, {Chi Huang} and Chen, {Ching Hui} and Tzeng, {Chii Ruey}",
year = "2019",
month = "9",
day = "1",
doi = "10.1016/j.tjog.2019.07.013",
language = "English",
volume = "58",
pages = "656--661",
journal = "Taiwanese Journal of Obstetrics and Gynecology",
issn = "1028-4559",
publisher = "臺灣婦產科醫學會",
number = "5",

}

TY - JOUR

T1 - A novel strategy of using corifollitropin alfa in the ultrashort gonadotropin-releasing hormone agonist (GnRHa) protocol in unselected patients

T2 - A patient-friendly alternative

AU - Yu, Tzu Ning

AU - Liu, Yung Liang

AU - Wang, Peng Hui

AU - Chen, Chi Huang

AU - Chen, Ching Hui

AU - Tzeng, Chii Ruey

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Objective: To compare the outcomes of in vitro fertilization (IVF) and fresh embryo transfer (ET) using corifollitropin alfa in ultrashort gonadotropin-releasing hormone agonist (GnRHa) protocol and GnRH antagonist protocol. Materials and methods: A total of 245 unselected patients undergoing IVF/fresh ET were enrolled between January 1 and December 31, 2017, including 135 treated with ultrashort GnRHa protocol and 110 treated with antagonist protocol. The primary outcomes were number of total injections and outpatient department (OPD) visits before ovulation triggering. The secondary outcomes were the duration of stimulation, dosage of additional gonadotropin for ovarian hyperstimulation, rates of pregnancy, clinical pregnancy, live birth, ovarian response, and ovarian hyperstimulation syndrome (OHSS) rate. Results: Patients treated with ultrashort GnRHa required less additional gonadotropin, fewer total injections, but had better ovarian responses, including more oocytes retrieved, more metaphase II oocytes, and more blastocysts than those treated with antagonist did. A premature LH surge occurred only in six patients treated with antagonist protocol. The rates of pregnancy (37.0% vs. 43.6%), clinical pregnancy (25.2% vs. 34.6%), and live birth (19.3% vs. 30.0%) did not differ significantly between the two groups. The OHSS rate was similar in the two groups. Conclusion: In unselected patients using corifollitropin alfa, the ultrashort GnRHa protocol needed lower dose of additional gonadotropin and fewer injections but produced similar pregnancy outcomes than antagonist protocol did, suggesting that the ultrashort GnRHa protocol could be an alternative.

AB - Objective: To compare the outcomes of in vitro fertilization (IVF) and fresh embryo transfer (ET) using corifollitropin alfa in ultrashort gonadotropin-releasing hormone agonist (GnRHa) protocol and GnRH antagonist protocol. Materials and methods: A total of 245 unselected patients undergoing IVF/fresh ET were enrolled between January 1 and December 31, 2017, including 135 treated with ultrashort GnRHa protocol and 110 treated with antagonist protocol. The primary outcomes were number of total injections and outpatient department (OPD) visits before ovulation triggering. The secondary outcomes were the duration of stimulation, dosage of additional gonadotropin for ovarian hyperstimulation, rates of pregnancy, clinical pregnancy, live birth, ovarian response, and ovarian hyperstimulation syndrome (OHSS) rate. Results: Patients treated with ultrashort GnRHa required less additional gonadotropin, fewer total injections, but had better ovarian responses, including more oocytes retrieved, more metaphase II oocytes, and more blastocysts than those treated with antagonist did. A premature LH surge occurred only in six patients treated with antagonist protocol. The rates of pregnancy (37.0% vs. 43.6%), clinical pregnancy (25.2% vs. 34.6%), and live birth (19.3% vs. 30.0%) did not differ significantly between the two groups. The OHSS rate was similar in the two groups. Conclusion: In unselected patients using corifollitropin alfa, the ultrashort GnRHa protocol needed lower dose of additional gonadotropin and fewer injections but produced similar pregnancy outcomes than antagonist protocol did, suggesting that the ultrashort GnRHa protocol could be an alternative.

KW - Antagonist protocol

KW - Corifollitropin alfa

KW - Fresh embryo transfer

KW - In vitro fertilization

KW - Ultrashort GnRHa protocol

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U2 - 10.1016/j.tjog.2019.07.013

DO - 10.1016/j.tjog.2019.07.013

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VL - 58

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JO - Taiwanese Journal of Obstetrics and Gynecology

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