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Chapter 21 - Triggering of final oocyte maturation in ovarian stimulation

from Section 6: - Procedures before, during, and after ovarian stimulation

Published online by Cambridge University Press:  05 August 2011

By
Georg Griesinger  and
Efstratios Kolibianakis
Edited by
Mohamed Aboulghar  and
Botros Rizk
Mohamed Aboulghar
Affiliation:
Cairo University and the IVF-ET Center
Botros Rizk
Affiliation:
University of South Alabama
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Summary

Oocyte maturation is the process by which the oocyte completes the first meiotic division and progresses to metaphase II. The main pharmacokinetic difference between luteinizing hormone (LH) and human chorionic gonadotropin (hCG) lies in the prolonged half-life of hCG. The pharmacokinetic behavior and the pharmacodynamic effect of hCG might vary according to body weight. The introduction of gonadotropin-releasing hormone (GnRH) agonists in ovarian stimulation protocols has allowed greater flexibility for the timing of hCG administration, because their use reliably prevented spontaneous LH surge and premature ovulation. Oocyte maturity, fertilization rates, and embryonic development were highly similar after agonist triggering and hCG triggering. A number of studies have reported a reduced likelihood of pregnancy after GnRH agonist triggering. GnRH agonist triggering of final oocyte maturation is an effective measure if the embryo transfer is spatially (oocyte donation) or temporally (frozen-thawed cycles) separated from agonist triggering and the ensuing luteal phase.

Keywords

gonadotropin releasing hormonehuman chorionic gonadotrpinin vitro fertilizationovarian hyperstimulationovarian stimulation protocolsoocyte maturationintracytoplasmic sperm injectionin vitro maturation
Type
Chapter
Information
Ovarian Stimulation , pp. 233 - 243
Publisher: Cambridge University Press
Print publication year: 2010

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