A novel GnRH-antagonist protocol by switching to medroxyprogesterone when patients being at risk of ovarian hyperstimulation syndrome during ovarian stimulation

Ting-Chi Huang; Yu-Hung Lin; Song-Po Pan; Yi-An Tu; Chu-Chun Huang; Mei-Jou Chen; Jiann-Loung Hwang; Shee-Uan Chen

Journal of the Formosan Medical Association (Nov 2020)

A novel GnRH-antagonist protocol by switching to medroxyprogesterone when patients being at risk of ovarian hyperstimulation syndrome during ovarian stimulation

Ting-Chi Huang,
Yu-Hung Lin,
Song-Po Pan,
Yi-An Tu,
Chu-Chun Huang,
Mei-Jou Chen,
Jiann-Loung Hwang,
Shee-Uan Chen

Affiliations

Ting-Chi Huang: Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
Yu-Hung Lin: Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Taipei Medical University, Taipei, Taiwan; School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
Song-Po Pan: Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
Yi-An Tu: Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
Chu-Chun Huang: Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
Mei-Jou Chen: Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan; Livia Shanyu Wan Scholar, College of Medicine, National Taiwan University, Taiwan
Jiann-Loung Hwang: Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Taipei Medical University, Taipei, Taiwan; IVF Taipei Clinic, Taipei, Taiwan
Shee-Uan Chen: Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan; Corresponding author. Department of Obstetrics and Gynecology, National Taiwan University Hospital, Address: No 7 Chung-Shan South Road, Taipei, Taiwan. Fax: +886 2 23116056.

Journal volume & issue: Vol. 119, no. 11
pp. 1642 – 1649

Abstract

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Background/Purpose: To investigate whether switching GnRH antagonist (GnRHant) to medroxyprogesterone acetate (MPA) sequentially in the middle of controlled ovarian stimulation could effectively prevent premature LH surge in a GnRHant protocol in patients turn out to be at a high risk of ovarian hyperstimulation syndrome (OHSS) during ovarian stimulation. Methods: This is a retrospective cohort study. Results: Premature LH surge did not occur in both groups of patients. The switch protocol group had a significantly fewer days of GnRHant treatment (3.1 ± 1.0 vs. 6.5 ± 1.2) compared with GnRHant protocol group. The mean duration of MPA treatment was 3.6 ± 1.1 days. There were no statistically significant differences in terms of live birth, implantation, and clinical pregnancy rates. Conclusion: This study showed that MPA could sequentially replace GnRHant and effectively prevent premature LH surge after several days of GnRHant administration in patients being at high risk of OHSS during controlled ovarian stimulation. Switch protocol could individualize freeze-all policy and reduce the injection burden of GnRHant.

Published in Journal of the Formosan Medical Association

ISSN: 0929-6646 (Print)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Medicine (General)
Website: http://www.journals.elsevier.com/journal-of-the-formosan-medical-association/

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