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Fresh Versus Frozen Embryo Transfer After Gonadotropin-Releasing Hormone Agonist Trigger in Gonadotropin-Releasing Hormone Antagonist Cycles Among High Responder Women: A Randomized, Multi-Center Study Publisher



Aflatoonian A1 ; Mansooritorshizi M2 ; Mojtahedi MF3 ; Aflatoonian B4, 5, 6 ; Khalili MA1, 5 ; Amirarjmand MH7 ; Soleimani M1 ; Aflatoonian N7 ; Oskouian H8 ; Tabibnejad N1 ; Humaidan P9
Authors
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Authors Affiliations
  1. 1. Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
  2. 2. Novin Infertility Center, Mashhad, Iran
  3. 3. Department of Obstetrics and Gynecology, Endocrinology and Female Infertility Unit, Roointan Arash Women’s Health Research and Educational Hospital, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Stem Cell Biology Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
  5. 5. Department of Reproductive Biology, School of Medici, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
  6. 6. Department of Advanced Medical Sciences and Technologies, School of Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
  7. 7. Madar Hosp, Yazd, Iran
  8. 8. Armaghan Infertility and IVF Clinic, Mashhad, Iran
  9. 9. Fertility Clinic, Skive Regional Hospital and Faculty of Health, Aarhus University, Aarhus, Denmark

Source: International Journal of Reproductive BioMedicine Published:2018


Abstract

Background: The use of embryo cryopreservation excludes the possible detrimental effects of ovarian stimulation on the endometrium, and higher reproductive outcomes following this policy have been reported. Moreover, gonadotropinreleasing hormone agonist trigger in gonadotropin-releasing hormone (GnRH) antagonist cycles as a substitute for standard human chorionic gonadotropin trigger, minimizes the risk of ovarian hyperstimulation syndrome (OHSS) in fresh as well as frozen embryo transfer cycles (FET). Objective: To compare the reproductive outcomes and risk of OHSS in fresh vs frozen embryo transfer in high responder patients, undergoing in vitro fertilization triggered with a bolus of GnRH agonist. Materials and Methods: In this randomized, multi-centre study, 121 women undergoing FET and 119 women undergoing fresh ET were investigated as regards clinical pregnancy as the primary outcome and the chemical pregnancy, live birth, OHSS development, and perinatal data as secondary outcomes. Results: There were no significant differences between FET and fresh groups regarding chemical (46.4% vs. 40.2%, p=0.352), clinical (35.8% vs. 38.3%, p=0.699), and ongoing (30.3% vs. 32.7%, p=0.700) pregnancy rates, also live birth (30.3% vs. 29.9%, p=0.953), perinatal outcomes, and OHSS development (35.6% vs. 42.9%, p=0.337). No woman developed severe OHSS and no one required admission to hospital. Conclusion: Our findings suggest that GnRHa trigger followed by fresh transfer with modified luteal phase support in terms of a small human chorionic gonadotropin bolus is a good strategy to secure good live birth rates and a low risk of clinically relevant OHSS development in in vitro fertilization patients at risk of OHSS. © 2018, Research and Clinical Center for Infertitlity. All rights reserved.
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