Infertility, Female Clinical Trial
Official title:
Agonist Trigger Versus Classical HCG Trigger in Controlled Ovarian Stimulation Among Three Different Subsets of Patients (Poor Responders, Normoresponders and High Responders)
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.
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.
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