Strategies for the management of ohss: results from freezing-all cycles
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://repositorio.unifesp.br/handle/11600/49232 http://dx.doi.org/10.5935/1518-0557.20160003 |
Resumo: | Objective: To compare the use of GnRH agonist (GnRHa) or hCG trigger in potential OHSS patients undergoing freeze-all programs. We also compared the clinical outcomes when fresh versus freeze-thawed embryo transfers were performed in cycles with a high number of retrieved oocytes. Methods: The study included potential OHSS patients who received GnRHa (n= 74) or hCG (n= 49) trigger. The protocols were compared with respect to the clinical outcomes. We also compared the clinical outcomes of cycles in which hCG trigger was used and more than 20 MII oocytes were retrieved when: fresh embryo transfer protocol (n= 153) or freeze-all protocol (n= 123) were performed. Results: A decreased serum estradiol level, a decreased number of retrieved oocytes, an increased MII retrieved rate, and decreased fertilization rate was observed in the hCG when compared with the GnRHa group. No significant differences were noted concerning clinical outcomes. When fresh cycles were compared with frozen-thawed cycles, the estradiol serum level and the number of cryopreserved embryos were higher in the frozen-thawed cycles. The clinical pregnancy rate was higher among freeze-all cycles, as well as the implantation and cumulative pregnancy rates, when compared with fresh embryo transfer cycles. Conclusion: The use of GnRHa trigger may be a good alternative to prevent the OHSS in patients presenting an extreme ovarian response to COS, leading to similar clinical outcomes, when compared with the traditional hCG trigger. Moreover, our findings demonstrated that the strategy of freezing-all embryos not only decreases the risk of OHSS but also leads to a better pregnancy rate. |
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Borges Junior, EdsonBraga, Daniela Paes Almeida Ferreira [UNIFESP]Setti, Amanda SouzaVingris, Livia S.Figueira, Rita Cássia SavioIaconelli Junior, Assumpto2019-01-21T10:29:28Z2019-01-21T10:29:28Z2016Jornal Brasileiro De Reproducao Assistida. Ribeirao, v. 20, n. 1, p. 8-12, 2016.1517-5693http://repositorio.unifesp.br/handle/11600/49232http://dx.doi.org/10.5935/1518-0557.2016000310.5935/1518-0557.20160003WOS:000405249100003Objective: To compare the use of GnRH agonist (GnRHa) or hCG trigger in potential OHSS patients undergoing freeze-all programs. We also compared the clinical outcomes when fresh versus freeze-thawed embryo transfers were performed in cycles with a high number of retrieved oocytes. Methods: The study included potential OHSS patients who received GnRHa (n= 74) or hCG (n= 49) trigger. The protocols were compared with respect to the clinical outcomes. We also compared the clinical outcomes of cycles in which hCG trigger was used and more than 20 MII oocytes were retrieved when: fresh embryo transfer protocol (n= 153) or freeze-all protocol (n= 123) were performed. Results: A decreased serum estradiol level, a decreased number of retrieved oocytes, an increased MII retrieved rate, and decreased fertilization rate was observed in the hCG when compared with the GnRHa group. No significant differences were noted concerning clinical outcomes. When fresh cycles were compared with frozen-thawed cycles, the estradiol serum level and the number of cryopreserved embryos were higher in the frozen-thawed cycles. The clinical pregnancy rate was higher among freeze-all cycles, as well as the implantation and cumulative pregnancy rates, when compared with fresh embryo transfer cycles. Conclusion: The use of GnRHa trigger may be a good alternative to prevent the OHSS in patients presenting an extreme ovarian response to COS, leading to similar clinical outcomes, when compared with the traditional hCG trigger. Moreover, our findings demonstrated that the strategy of freezing-all embryos not only decreases the risk of OHSS but also leads to a better pregnancy rate.Fertility – Medical Group - Sao Paulo – Brazil[Borges, Edson, Jr.Sapientiae Institute – Centro de Estudos e Pesquisa em Reprodução AssistidaDisciplina de Urologia, Área de Reprodução Humana, Departamento de Cirurgia, Universidade Federal de São PauloDisciplina de Urologia, Área de Reprodução Humana, Departamento de Cirurgia, Universidade Federal de São PauloWeb of Science8-12engRevista De Saude PublicaJornal Brasileiro De Reproducao AssistidaOhssFreezingThawingHcgGnrhaTriggerOvarian Hyperstimulation SyndromeFinal Oocyte MaturationIn-Vitro FertilizationLow-Dose HcgGnrh AgonistEmbryo-TransferInjectionFreshCombinationPreventionStrategies for the management of ohss: results from freezing-all cyclesinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP11600/492322021-09-30 11:04:49.202metadata only accessoai:repositorio.unifesp.br:11600/49232Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-05-25T12:13:20.028225Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Strategies for the management of ohss: results from freezing-all cycles |
title |
Strategies for the management of ohss: results from freezing-all cycles |
spellingShingle |
Strategies for the management of ohss: results from freezing-all cycles Borges Junior, Edson Ohss Freezing Thawing Hcg Gnrha TriggerOvarian Hyperstimulation Syndrome Final Oocyte Maturation In-Vitro Fertilization Low-Dose Hcg Gnrh Agonist Embryo-Transfer Injection Fresh Combination Prevention |
title_short |
Strategies for the management of ohss: results from freezing-all cycles |
title_full |
Strategies for the management of ohss: results from freezing-all cycles |
title_fullStr |
Strategies for the management of ohss: results from freezing-all cycles |
title_full_unstemmed |
Strategies for the management of ohss: results from freezing-all cycles |
title_sort |
Strategies for the management of ohss: results from freezing-all cycles |
author |
Borges Junior, Edson |
author_facet |
Borges Junior, Edson Braga, Daniela Paes Almeida Ferreira [UNIFESP] Setti, Amanda Souza Vingris, Livia S. Figueira, Rita Cássia Savio Iaconelli Junior, Assumpto |
author_role |
author |
author2 |
Braga, Daniela Paes Almeida Ferreira [UNIFESP] Setti, Amanda Souza Vingris, Livia S. Figueira, Rita Cássia Savio Iaconelli Junior, Assumpto |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Borges Junior, Edson Braga, Daniela Paes Almeida Ferreira [UNIFESP] Setti, Amanda Souza Vingris, Livia S. Figueira, Rita Cássia Savio Iaconelli Junior, Assumpto |
dc.subject.eng.fl_str_mv |
Ohss Freezing Thawing Hcg Gnrha TriggerOvarian Hyperstimulation Syndrome Final Oocyte Maturation In-Vitro Fertilization Low-Dose Hcg Gnrh Agonist Embryo-Transfer Injection Fresh Combination Prevention |
topic |
Ohss Freezing Thawing Hcg Gnrha TriggerOvarian Hyperstimulation Syndrome Final Oocyte Maturation In-Vitro Fertilization Low-Dose Hcg Gnrh Agonist Embryo-Transfer Injection Fresh Combination Prevention |
description |
Objective: To compare the use of GnRH agonist (GnRHa) or hCG trigger in potential OHSS patients undergoing freeze-all programs. We also compared the clinical outcomes when fresh versus freeze-thawed embryo transfers were performed in cycles with a high number of retrieved oocytes. Methods: The study included potential OHSS patients who received GnRHa (n= 74) or hCG (n= 49) trigger. The protocols were compared with respect to the clinical outcomes. We also compared the clinical outcomes of cycles in which hCG trigger was used and more than 20 MII oocytes were retrieved when: fresh embryo transfer protocol (n= 153) or freeze-all protocol (n= 123) were performed. Results: A decreased serum estradiol level, a decreased number of retrieved oocytes, an increased MII retrieved rate, and decreased fertilization rate was observed in the hCG when compared with the GnRHa group. No significant differences were noted concerning clinical outcomes. When fresh cycles were compared with frozen-thawed cycles, the estradiol serum level and the number of cryopreserved embryos were higher in the frozen-thawed cycles. The clinical pregnancy rate was higher among freeze-all cycles, as well as the implantation and cumulative pregnancy rates, when compared with fresh embryo transfer cycles. Conclusion: The use of GnRHa trigger may be a good alternative to prevent the OHSS in patients presenting an extreme ovarian response to COS, leading to similar clinical outcomes, when compared with the traditional hCG trigger. Moreover, our findings demonstrated that the strategy of freezing-all embryos not only decreases the risk of OHSS but also leads to a better pregnancy rate. |
publishDate |
2016 |
dc.date.issued.fl_str_mv |
2016 |
dc.date.accessioned.fl_str_mv |
2019-01-21T10:29:28Z |
dc.date.available.fl_str_mv |
2019-01-21T10:29:28Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Jornal Brasileiro De Reproducao Assistida. Ribeirao, v. 20, n. 1, p. 8-12, 2016. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/handle/11600/49232 http://dx.doi.org/10.5935/1518-0557.20160003 |
dc.identifier.issn.none.fl_str_mv |
1517-5693 |
dc.identifier.doi.none.fl_str_mv |
10.5935/1518-0557.20160003 |
dc.identifier.wos.none.fl_str_mv |
WOS:000405249100003 |
identifier_str_mv |
Jornal Brasileiro De Reproducao Assistida. Ribeirao, v. 20, n. 1, p. 8-12, 2016. 1517-5693 10.5935/1518-0557.20160003 WOS:000405249100003 |
url |
http://repositorio.unifesp.br/handle/11600/49232 http://dx.doi.org/10.5935/1518-0557.20160003 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.none.fl_str_mv |
Jornal Brasileiro De Reproducao Assistida |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
8-12 |
dc.publisher.none.fl_str_mv |
Revista De Saude Publica |
publisher.none.fl_str_mv |
Revista De Saude Publica |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
|
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1783460264184643584 |