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Abstract
The use of gonadotrophin-releasing hormone (GnRH) agonists for triggering ovulation
remains controversial. The primary objective of this study was to evaluate the incidence
of ovarian hyperstimulation syndrome (OHSS) following GnRH agonist versus recombinant
human chorionic gonadotrophin (HCG) as methods for triggering ovulation. A second
aim was to compare the clinical outcome and embryo quality according to the two procedures.
The cycle characteristics of 100 oocyte donors undergoing ovarian stimulation and
IVF outcomes of their 100 oocyte recipients were analysed. Donors were prospectively
randomized into two groups on the last day of ovarian stimulation: Group I received
a single bolus of 0.2 mg of triptorelin and Group II received 250 microg of recombinant
HCG. No differences were observed in the number of oocytes retrieved or in the proportion
of metaphase II oocytes between the groups. The OHSS rate was higher in donors that
received recombinant HCG ( P = 0.003). Moreover, there was no significant difference
between IVF parameters and outcome in the two groups. In conclusion, a GnRH agonist
effectively triggers the final oocyte maturation in oocyte donors without negatively
affecting implantation, pregnancy or miscarriage rates. Moreover, this regime effectively
eliminates the risk of OHSS in this group of women.