@article {608958,
	title = {A novel oocyte maturation trigger using 1500~IU of human chorionic gonadotropin plus 450~IU of follicle-stimulating hormone may decrease ovarian hyperstimulation syndrome across all in vitro fertilization stimulation protocols},
	journal = {J Assist Reprod Genet},
	volume = {35},
	number = {2},
	year = {2018},
	month = {2018 Feb},
	pages = {297-307},
	abstract = {PURPOSE: Modification of the trigger used to induce final oocyte maturation in in vitro fertilization (IVF) is a major strategy used to reduce the risk of ovarian hyperstimulation syndrome (OHSS). A novel trigger composed of 1500~IU of human chorionic gonadotropin (hCG) plus 450~IU of follicle-stimulating hormone (FSH) has been developed to reduce OHSS risk. This study compares outcomes of the novel trigger to conventional triggers used in high-risk OHSS patients undergoing IVF.

METHODS: In this retrospective cohort study, IVF cycles at high risk for OHSS based on a serum estradiol >~5000~pg/ml on trigger day conducted between January 2008 and February 2016 were evaluated. Oocyte maturation was induced with the novel trigger (1500~IU hCG plus 450~IU FSH) or a conventional trigger [3300~IU hCG, gonadotropin-releasing hormone agonist (GnRHa) alone, or GnRHa plus 1500~IU hCG]. IVF cycle outcomes were compared. Trigger strategies were examined for associations with OHSS development using logistic regression.

RESULTS: Among 298 eligible IVF cycles identified, there were no differences in oocyte maturation, fertilization, embryo quality, or pregnancy outcomes among all triggers. After adjusting for serum estradiol level and number of follicles, the novel trigger was associated with lower odds of OHSS symptom development compared to the 3300~IU hCG and GnRHa plus hCG 1500~IU triggers (p~=~0.007 and 0.04, respectively).

CONCLUSIONS: This study suggests that 1500~IU hCG plus 450~IU FSH may be associated with decreased OHSS symptoms compared to conventional triggers, while producing similar IVF and pregnancy outcomes. More important, this novel trigger may provide a superior alternative in down-regulated cycles and in patients with hypothalamic dysfunction where GnRHa triggers cannot be utilized.},
	issn = {1573-7330},
	doi = {10.1007/s10815-017-1074-4},
	author = {Anaya, Yanett and Mata, Douglas A and Letourneau, Joseph and Cakmak, Hakan and Cedars, Marcelle I and Rosen, Mitchell P}
}
