Ectopic pregnancy risk factors for ART patients undergoing the GnRH antagonist protocol: a retrospective study

Weiss, Amir; Beck-Fruchter, Ronit; Golan, Joanne; Lavee, Michal; Geslevich, Yoel; Shalev, Eliezer

doi:10.1186/s12958-016-0146-0

Cited by 25 publications

(27 citation statements)

References 61 publications

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“…An increased risk for EUP was reported in GnRH antagonist fresh autologous cycles as compared to the luteal GnRHa long protocol [36]. It has also been suggested that GnRHa triggering might be related to a higher incidence of EUP [37][38][39]. In this study, only 3 EUP occurred, and hence, no conclusion can be drawn.…”

Section: Discussioncontrasting

confidence: 53%

Gonadotropin Releasing Hormone Agonist Final Oocyte Maturation and Human Chorionic Gonadotropin as Exclusive Luteal Support in Normal Responders

Beck-Fruchter

Baram

Geslevich

et al. 2018

Gynecol Obstet Invest

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Background/Aims: Gonadotropin releasing hormone (GnRH) agonist triggering results in an endogenous gonadotropin flare. Although it effectively stimulates ovulation, GnRH agonist triggers results in an early luteolysis and requires modification of the luteal support. The current study aims to evaluate GnRH agonist triggering with exclusive human chorionic gonadotropin (hCG) luteal support. Methods: In this prospective observational study, 56 normogonadotropic-assisted reproductive technology patients, stimulated using a GnRH-antagonist protocol, were studied. Final oocyte maturation was achieved with 0.2 mg triptorelin acetate followed by progesterone free luteal support with human choriogonadotropin (1,500 IU * 2). A control group was selected from a pool of 1,023 normogonadotropic patients who received Choriogonadotropin alfa for final oocyte maturation and progesterone suppositories for luteal support. Results: No significant difference was found for the number of oocytes, oocyte maturation rate, fertilization and implantation rate, clinical pregnancy rate (25 vs. 26.7%) and live birth rate (25 vs. 21.4%). Progesterone levels in conception cycles were significantly higher in the study group than corresponding levels in the control group. Conclusion: GnRH agonist triggering with exclusive hCG support may be a valid alternative to hCG triggering with progesterone support. This protocol combines the potential advantages of a physiological trigger with a simple, patient-friendly, luteal support.

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Section: Discussioncontrasting

confidence: 53%

Gonadotropin Releasing Hormone Agonist Final Oocyte Maturation and Human Chorionic Gonadotropin as Exclusive Luteal Support in Normal Responders

Beck-Fruchter

Baram

Geslevich

et al. 2018

Gynecol Obstet Invest

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“…In addition, luteal GnRH antagonist administration in women with severe early ovarian hyperstimulation syndrome (OHSS) is associated not only with not different live birth rates but also with similar duration of gestation (36.9 ± 0.9 vs. 36.9 ± 2.4 weeks) and neonatal weight (2392 ± 427 vs. 2646 ± 655 g) when compared to patients who do not receive the treatment [47]. However, in patients undergoing COH using the GnRH antagonist protocol, GnRH agonist trigger were found to be independent risk factors for ectopic pregnancy [48]. …”

Section: Resultsmentioning

confidence: 99%

Risk of adverse pregnancy and perinatal outcomes after high technology infertility treatment: a comprehensive systematic review

Palomba

Homburg

Santagni

et al. 2016

Reprod Biol Endocrinol

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In the literature, there is growing evidence that subfertile patients who conceived after infertility treatments have an increased risk of pregnancy and perinatal complications and this is particularly true for patients who conceived through use of high technology infertility treatments. Moreover, high technology infertility treatments include many concomitant clinical and biological risk factors. This review aims to summarize in a systematic fashion the current evidence regarding the relative effect of the different procedures for high technology infertility treatments on the risk of adverse pregnancy and perinatal outcome. A literature search up to August 2016 was performed in IBSS, SocINDEX, Institute for Scientific Information, PubMed, Web of Science and Google Scholar and an evidence-based hierarchy was used to determine which articles to include and analyze. Data on prepregnancy maternal factors, low technology interventions, specific procedures for male factor, ovarian tissue/ovary and uterus transplantation, and chromosomal abnormalities and malformations of the offspring were excluded. The available evidences were analyzed assessing the level and the quality of evidence according to the Oxford Centre for Evidence-Based Medicine guidelines and the Grading of Recommendations Assessment, Development, and Evaluation system, respectively. Current review highlights that every single procedure of high technology infertility treatments can play a crucial role in increasing the risk of pregnancy and perinatal complications. Due to the suboptimal level and quality of the current evidence, further well-designed studies are needed.

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“…No TET was performed in the center. Our protocols for COS, endometrial preparation, as well as laboratory procedures have been described elsewhere [14][15][16].…”

Section: Systematic Review and Meta-analysismentioning

confidence: 99%

Ectopic pregnancy followingin vitrofertilization: meta-analysis and single-center experience during 6 years

Müller

Makhmadalieva

Kogan

et al. 2016

Gynecological Endocrinology

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Background: Ectopic pregnancy (EP) has been reported to occur in 1.4-5.4% of all clinical pregnancies resulting from in vitro fertilization (IVF) and embryo transfer (ET). Data on factors associated with abnormal embryo implantation following assisted conception are limited. Materials and methods: A systematic review and meta-analysis was performed to determine whether there is an association between the day (cleavage-stage, D3, versus blastocyst, D5) or the type (fresh versus frozen/thawed) of ET and EP rate. Risk factors for EP were evaluated in a retrospective study of 1194 women, who achieved pregnancy at our IVF unit between 2010 and 2016. Results: Sixteen papers were considered for the meta-analysis. EP rate did not differ between D3 and D5 fresh ET groups (RR ¼ 0.99, 95%CI: 0.76-1.30) and was higher after fresh versus frozen ET (RR ¼ 1.56, 95%CI: 1.25-1.95). At our clinic, 21 (1.76%) pregnancies were documented as ectopic. The risk of EP was associated with tubal pathology (OR ¼ 3.37, 95%CI: 1.39-8.2), previous appendectomy and past chlamydial infection. Conclusions: Present meta-analysis suggests that EP rate is similar following fresh blastocyst and cleavage ETs, but is significantly reduced after frozen compared with fresh ET. Our own findings demonstrate that tubal pathology has the major impact on EP occurrence following assisted conception.

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Ectopic pregnancy risk factors for ART patients undergoing the GnRH antagonist protocol: a retrospective study

Cited by 25 publications

References 61 publications

Gonadotropin Releasing Hormone Agonist Final Oocyte Maturation and Human Chorionic Gonadotropin as Exclusive Luteal Support in Normal Responders

Gonadotropin Releasing Hormone Agonist Final Oocyte Maturation and Human Chorionic Gonadotropin as Exclusive Luteal Support in Normal Responders

Risk of adverse pregnancy and perinatal outcomes after high technology infertility treatment: a comprehensive systematic review

Ectopic pregnancy followingin vitrofertilization: meta-analysis and single-center experience during 6 years

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