Prapas Y, et al. – Analysts explore whether a double antagonist dose (0.25 mg/12 h) administered the day before hCG trigger is successful in preventing ovarian hyperstimulation syndrome (OHSS) in GnRH antagonist IVF/intracytoplasmic sperm injection (ICSI) cycles at risk for OHSS. The administration of a rescue double GnRH antagonist dose the day before hCG trigger may represent a safe option preventive strategy for early OHSS without influencing the reproductive outcomes.

Methods

• For this research, they designed a prospective randomized control study.
• This study was conducted from November 2012 to January 2016.
• A total of 194 patients undergoing a IVF/ICSI GnRH antagonist cycle that were at risk of OHSS and chose to proceed with embryo transfer and avoid cycle cancellation or embryo cryopreservation were selected for this study.
• All the participants were allocated into two groups.
• The inclusion criteria consisted of a rapid rise of oestradiol ≥ 3500 pg/ml combined with ≥ 18 follicles > 11 mm in diameter without any mature follicle > 16 mm, in any day of stimulation.
• Overall, 97 patients (intervention group A) received a double dose of GnRH antagonist (0.25 mg/12 h) the day before hCG while 97 patients (control group B) did not.
• Recombinant FSH administration was tapered to 100 IU/24 h the day of the allocation in both groups.

Results

• In this study, they found incidence of early–onset moderate/severe OHSS was significantly lower in intervention group A compared to control group B (0 vs 12.37%, P < 0.001).
• Between these two groups, clinical pregnancy rate per cycle (50.52 vs 42.27%, P = 0.249) was not significantly different.
• Oestradiol (3263.471 ± 1271.53 vs 5233 ± 1425.17, P < 0.001), progesterone (0.93 ± 0.12 vs 1.29 ± 0.14, P < 0.001) and luteinizing hormone (1.42 ± 0.31 vs 1.91 ± 0.33, P < 0.001) were significantly lower in group A the day of the hCG triggering.