Sliding scale HCG trigger yields equivalent pregnancy outcomes and reduces ovarian hyperstimulation syndrome: Analysis of 10,427 IVF-ICSI cycles
To evaluate pregnancy outcomes and the incidence of ovarian hyperstimulation syndrome (OHSS) using a sliding scale hCG protocol to trigger oocyte maturity and establish a threshold level of serum b-hCG associated with optimal oocyte maturity. Retrospective cohort. Academic medical center. Fresh IVF...
Gespeichert in:
| Veröffentlicht in: | PloS one 2017-04, Vol.12 (4), p.e0176019-e0176019 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e0176019 |
|---|---|
| container_issue | 4 |
| container_start_page | e0176019 |
| container_title | PloS one |
| container_volume | 12 |
| creator | Gunnala, Vinay Melnick, Alexis Irani, Mohamad Reichman, David Schattman, Glenn Davis, Owen Rosenwaks, Zev |
| description | To evaluate pregnancy outcomes and the incidence of ovarian hyperstimulation syndrome (OHSS) using a sliding scale hCG protocol to trigger oocyte maturity and establish a threshold level of serum b-hCG associated with optimal oocyte maturity.
Retrospective cohort.
Academic medical center.
Fresh IVF cycles from 9/2004-12/2011.
10,427 fresh IVF-ICSI cycles met inclusion criteria. hCG was administered according to E2 level at trigger: 10,000IU vs. 5,000IU vs. 4,000IU vs. 3,300IU vs. dual trigger (2mg leuprolide acetate + 1,500IU hCG). Serum absorption of hCG was assessed according to dose and BMI.
Oocyte maturity was analyzed according to post-trigger serum b-hCG. Fertilization, clinical pregnancy, live birth and OHSS rates were examined by hCG trigger dose.
Post-trigger serum b-hCG 20-30, 30-40, and 40-50 mIU/mL was associated with reduced oocyte maturity as compared b-hCG >50 (67.8% vs. 71.4% vs. 73.3% vs. 78.9%, respectively, P |
| doi_str_mv | 10.1371/journal.pone.0176019 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_1891907965</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A493764902</galeid><doaj_id>oai_doaj_org_article_22dad90e1c714b11b0bea3ae842ab463</doaj_id><sourcerecordid>A493764902</sourcerecordid><originalsourceid>FETCH-LOGICAL-c692t-319afd50f99410e11841a0671cafe753d850e8548ba12512bfa621df3f31d7393</originalsourceid><addsrcrecordid>eNqNk11rFDEUhgdRbK3-A9FAQRTcNV_zES-EZbHtQqHgam9DJsnMpmSTbTKzOP_Cn2z2o2VXeiG5SEie8543JzlZ9hbBMSIl-nLn--CEHa-802OIygIi9iw7RYzgUYEheX6wPslexXgHYU6qoniZneCKUkQLdJr9mVujjGtBlMJqcDW9BF0wbasDGIy2KgJ935t1OnMdWAXdOuHkAHzfSb_UEQinQNCql2nt1yIY4cBiWOkQO7PsreiMdyAOToWEfwWT5HiIJrENQPAzxSWY3V6MZtP5DMhBWh1fZy8aYaN-s5_Psl8X339Or0bXN5ez6eR6JAuGuxFBTDQqhw1jFEGNUEWRgEWJpGh0mRNV5VBXOa1qgXCOcN2IAiPVkIYgVRJGzrL3O92V9ZHvixk5qhhisGRFnojZjlBe3PFVMEsRBu6F4dsNH1ouQmeSaY6xEoolG7JEtEaohrUWROiKYlHTgiStb_tsfb3USqZqBmGPRI9PnFnw1q95TiEtt2Y-7gWCv-917PjSRKmtFU77fusbE4IJ3KDn_6BP325PteltuXGNT3nlRpRPKCNlQRnEiRo_QaWh9NLI9PMak_aPAj4dBSSm07-7VvQx8tn8x_-zN7fH7IcDdqGF7RbR237zv-IxSHegDD7GoJvHIiPIN43zUA2-aRy-b5wU9u7wgR6DHjqF_AXg1BNU</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1891907965</pqid></control><display><type>article</type><title>Sliding scale HCG trigger yields equivalent pregnancy outcomes and reduces ovarian hyperstimulation syndrome: Analysis of 10,427 IVF-ICSI cycles</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Public Library of Science (PLoS)</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Gunnala, Vinay ; Melnick, Alexis ; Irani, Mohamad ; Reichman, David ; Schattman, Glenn ; Davis, Owen ; Rosenwaks, Zev</creator><contributor>Zenclussen, Ana Claudia</contributor><creatorcontrib>Gunnala, Vinay ; Melnick, Alexis ; Irani, Mohamad ; Reichman, David ; Schattman, Glenn ; Davis, Owen ; Rosenwaks, Zev ; Zenclussen, Ana Claudia</creatorcontrib><description>To evaluate pregnancy outcomes and the incidence of ovarian hyperstimulation syndrome (OHSS) using a sliding scale hCG protocol to trigger oocyte maturity and establish a threshold level of serum b-hCG associated with optimal oocyte maturity.
Retrospective cohort.
Academic medical center.
Fresh IVF cycles from 9/2004-12/2011.
10,427 fresh IVF-ICSI cycles met inclusion criteria. hCG was administered according to E2 level at trigger: 10,000IU vs. 5,000IU vs. 4,000IU vs. 3,300IU vs. dual trigger (2mg leuprolide acetate + 1,500IU hCG). Serum absorption of hCG was assessed according to dose and BMI.
Oocyte maturity was analyzed according to post-trigger serum b-hCG. Fertilization, clinical pregnancy, live birth and OHSS rates were examined by hCG trigger dose.
Post-trigger serum b-hCG 20-30, 30-40, and 40-50 mIU/mL was associated with reduced oocyte maturity as compared b-hCG >50 (67.8% vs. 71.4% vs. 73.3% vs. 78.9%, respectively, P<0.05). b-hCG 20-50 mIU/mL was associated with a 40.1% reduction in live birth (OR 0.59, 95% CI 0.41-0.87). No differences in IVF outcomes per retrieval were seen for varying doses of hCG or dual trigger when controlling for patient age. The incidence of moderate to severe OHSS was 0.13% (n = 14) and severe OHSS was 0.03% (n = 4) of cycles.
Moderate stimulation with sliding scale hCG at trigger and fresh transfer is associated with low rates of OHSS and favorable pregnancy rates. Doses as low as 3,300IU alone or dual trigger with 1,500IU are sufficient to facilitate oocyte maturity.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0176019</identifier><identifier>PMID: 28441461</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>17β-Estradiol ; Abortion ; Adult ; Analysis ; Antagonists ; Biology ; Biology and Life Sciences ; Chorionic gonadotropin ; Chorionic Gonadotropin - administration & dosage ; Chorionic Gonadotropin - therapeutic use ; Chorionic gonadotropins ; Coasting ; Cohen, Claudia ; Computer programs ; Conferences ; Criteria ; Cryopreservation ; Diagnosis ; Dosage and administration ; Drug dosages ; Embryo transfer ; Embryos ; Estrogen receptors ; Female ; Fertilization ; Fertilization in Vitro ; Follicle-stimulating hormone ; Follicles ; Freeze thaw cycles ; Freeze-thawing ; Genetic screening ; Gonadotropin-releasing hormone ; Gonadotropins ; Gynecology ; Health aspects ; Humans ; In vitro fertilization ; In vitro methods and tests ; Incidence ; Infertility ; Leuprolide ; Maturity ; Medicine ; Medicine and Health Sciences ; Methods ; Middle Aged ; Molecular biology ; Obstetrics ; Ovarian Hyperstimulation Syndrome - epidemiology ; Ovarian Hyperstimulation Syndrome - prevention & control ; Ovulation Induction - adverse effects ; Ovulation Induction - methods ; Patients ; People and Places ; Pituitary (anterior) ; Populations ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Prevention ; Protocol (computers) ; Reproduction ; Reproductive Control Agents - administration & dosage ; Reproductive Control Agents - therapeutic use ; Reproductive health ; Reproductive technologies ; Retrieval ; Retrospective Studies ; Risk factors ; Sperm ; Sperm Injections, Intracytoplasmic ; Stem cells ; Stimulation ; Vascular endothelial growth factor</subject><ispartof>PloS one, 2017-04, Vol.12 (4), p.e0176019-e0176019</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Gunnala et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Gunnala et al 2017 Gunnala et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-319afd50f99410e11841a0671cafe753d850e8548ba12512bfa621df3f31d7393</citedby><cites>FETCH-LOGICAL-c692t-319afd50f99410e11841a0671cafe753d850e8548ba12512bfa621df3f31d7393</cites><orcidid>0000-0003-4231-6989</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5404765/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5404765/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28441461$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Zenclussen, Ana Claudia</contributor><creatorcontrib>Gunnala, Vinay</creatorcontrib><creatorcontrib>Melnick, Alexis</creatorcontrib><creatorcontrib>Irani, Mohamad</creatorcontrib><creatorcontrib>Reichman, David</creatorcontrib><creatorcontrib>Schattman, Glenn</creatorcontrib><creatorcontrib>Davis, Owen</creatorcontrib><creatorcontrib>Rosenwaks, Zev</creatorcontrib><title>Sliding scale HCG trigger yields equivalent pregnancy outcomes and reduces ovarian hyperstimulation syndrome: Analysis of 10,427 IVF-ICSI cycles</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>To evaluate pregnancy outcomes and the incidence of ovarian hyperstimulation syndrome (OHSS) using a sliding scale hCG protocol to trigger oocyte maturity and establish a threshold level of serum b-hCG associated with optimal oocyte maturity.
Retrospective cohort.
Academic medical center.
Fresh IVF cycles from 9/2004-12/2011.
10,427 fresh IVF-ICSI cycles met inclusion criteria. hCG was administered according to E2 level at trigger: 10,000IU vs. 5,000IU vs. 4,000IU vs. 3,300IU vs. dual trigger (2mg leuprolide acetate + 1,500IU hCG). Serum absorption of hCG was assessed according to dose and BMI.
Oocyte maturity was analyzed according to post-trigger serum b-hCG. Fertilization, clinical pregnancy, live birth and OHSS rates were examined by hCG trigger dose.
Post-trigger serum b-hCG 20-30, 30-40, and 40-50 mIU/mL was associated with reduced oocyte maturity as compared b-hCG >50 (67.8% vs. 71.4% vs. 73.3% vs. 78.9%, respectively, P<0.05). b-hCG 20-50 mIU/mL was associated with a 40.1% reduction in live birth (OR 0.59, 95% CI 0.41-0.87). No differences in IVF outcomes per retrieval were seen for varying doses of hCG or dual trigger when controlling for patient age. The incidence of moderate to severe OHSS was 0.13% (n = 14) and severe OHSS was 0.03% (n = 4) of cycles.
Moderate stimulation with sliding scale hCG at trigger and fresh transfer is associated with low rates of OHSS and favorable pregnancy rates. Doses as low as 3,300IU alone or dual trigger with 1,500IU are sufficient to facilitate oocyte maturity.</description><subject>17β-Estradiol</subject><subject>Abortion</subject><subject>Adult</subject><subject>Analysis</subject><subject>Antagonists</subject><subject>Biology</subject><subject>Biology and Life Sciences</subject><subject>Chorionic gonadotropin</subject><subject>Chorionic Gonadotropin - administration & dosage</subject><subject>Chorionic Gonadotropin - therapeutic use</subject><subject>Chorionic gonadotropins</subject><subject>Coasting</subject><subject>Cohen, Claudia</subject><subject>Computer programs</subject><subject>Conferences</subject><subject>Criteria</subject><subject>Cryopreservation</subject><subject>Diagnosis</subject><subject>Dosage and administration</subject><subject>Drug dosages</subject><subject>Embryo transfer</subject><subject>Embryos</subject><subject>Estrogen receptors</subject><subject>Female</subject><subject>Fertilization</subject><subject>Fertilization in Vitro</subject><subject>Follicle-stimulating hormone</subject><subject>Follicles</subject><subject>Freeze thaw cycles</subject><subject>Freeze-thawing</subject><subject>Genetic screening</subject><subject>Gonadotropin-releasing hormone</subject><subject>Gonadotropins</subject><subject>Gynecology</subject><subject>Health aspects</subject><subject>Humans</subject><subject>In vitro fertilization</subject><subject>In vitro methods and tests</subject><subject>Incidence</subject><subject>Infertility</subject><subject>Leuprolide</subject><subject>Maturity</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Molecular biology</subject><subject>Obstetrics</subject><subject>Ovarian Hyperstimulation Syndrome - epidemiology</subject><subject>Ovarian Hyperstimulation Syndrome - prevention & control</subject><subject>Ovulation Induction - adverse effects</subject><subject>Ovulation Induction - methods</subject><subject>Patients</subject><subject>People and Places</subject><subject>Pituitary (anterior)</subject><subject>Populations</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Pregnancy Rate</subject><subject>Prevention</subject><subject>Protocol (computers)</subject><subject>Reproduction</subject><subject>Reproductive Control Agents - administration & dosage</subject><subject>Reproductive Control Agents - therapeutic use</subject><subject>Reproductive health</subject><subject>Reproductive technologies</subject><subject>Retrieval</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Sperm</subject><subject>Sperm Injections, Intracytoplasmic</subject><subject>Stem cells</subject><subject>Stimulation</subject><subject>Vascular endothelial growth factor</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk11rFDEUhgdRbK3-A9FAQRTcNV_zES-EZbHtQqHgam9DJsnMpmSTbTKzOP_Cn2z2o2VXeiG5SEie8543JzlZ9hbBMSIl-nLn--CEHa-802OIygIi9iw7RYzgUYEheX6wPslexXgHYU6qoniZneCKUkQLdJr9mVujjGtBlMJqcDW9BF0wbasDGIy2KgJ935t1OnMdWAXdOuHkAHzfSb_UEQinQNCql2nt1yIY4cBiWOkQO7PsreiMdyAOToWEfwWT5HiIJrENQPAzxSWY3V6MZtP5DMhBWh1fZy8aYaN-s5_Psl8X339Or0bXN5ez6eR6JAuGuxFBTDQqhw1jFEGNUEWRgEWJpGh0mRNV5VBXOa1qgXCOcN2IAiPVkIYgVRJGzrL3O92V9ZHvixk5qhhisGRFnojZjlBe3PFVMEsRBu6F4dsNH1ouQmeSaY6xEoolG7JEtEaohrUWROiKYlHTgiStb_tsfb3USqZqBmGPRI9PnFnw1q95TiEtt2Y-7gWCv-917PjSRKmtFU77fusbE4IJ3KDn_6BP325PteltuXGNT3nlRpRPKCNlQRnEiRo_QaWh9NLI9PMak_aPAj4dBSSm07-7VvQx8tn8x_-zN7fH7IcDdqGF7RbR237zv-IxSHegDD7GoJvHIiPIN43zUA2-aRy-b5wU9u7wgR6DHjqF_AXg1BNU</recordid><startdate>20170425</startdate><enddate>20170425</enddate><creator>Gunnala, Vinay</creator><creator>Melnick, Alexis</creator><creator>Irani, Mohamad</creator><creator>Reichman, David</creator><creator>Schattman, Glenn</creator><creator>Davis, Owen</creator><creator>Rosenwaks, Zev</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-4231-6989</orcidid></search><sort><creationdate>20170425</creationdate><title>Sliding scale HCG trigger yields equivalent pregnancy outcomes and reduces ovarian hyperstimulation syndrome: Analysis of 10,427 IVF-ICSI cycles</title><author>Gunnala, Vinay ; Melnick, Alexis ; Irani, Mohamad ; Reichman, David ; Schattman, Glenn ; Davis, Owen ; Rosenwaks, Zev</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-319afd50f99410e11841a0671cafe753d850e8548ba12512bfa621df3f31d7393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>17β-Estradiol</topic><topic>Abortion</topic><topic>Adult</topic><topic>Analysis</topic><topic>Antagonists</topic><topic>Biology</topic><topic>Biology and Life Sciences</topic><topic>Chorionic gonadotropin</topic><topic>Chorionic Gonadotropin - administration & dosage</topic><topic>Chorionic Gonadotropin - therapeutic use</topic><topic>Chorionic gonadotropins</topic><topic>Coasting</topic><topic>Cohen, Claudia</topic><topic>Computer programs</topic><topic>Conferences</topic><topic>Criteria</topic><topic>Cryopreservation</topic><topic>Diagnosis</topic><topic>Dosage and administration</topic><topic>Drug dosages</topic><topic>Embryo transfer</topic><topic>Embryos</topic><topic>Estrogen receptors</topic><topic>Female</topic><topic>Fertilization</topic><topic>Fertilization in Vitro</topic><topic>Follicle-stimulating hormone</topic><topic>Follicles</topic><topic>Freeze thaw cycles</topic><topic>Freeze-thawing</topic><topic>Genetic screening</topic><topic>Gonadotropin-releasing hormone</topic><topic>Gonadotropins</topic><topic>Gynecology</topic><topic>Health aspects</topic><topic>Humans</topic><topic>In vitro fertilization</topic><topic>In vitro methods and tests</topic><topic>Incidence</topic><topic>Infertility</topic><topic>Leuprolide</topic><topic>Maturity</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Methods</topic><topic>Middle Aged</topic><topic>Molecular biology</topic><topic>Obstetrics</topic><topic>Ovarian Hyperstimulation Syndrome - epidemiology</topic><topic>Ovarian Hyperstimulation Syndrome - prevention & control</topic><topic>Ovulation Induction - adverse effects</topic><topic>Ovulation Induction - methods</topic><topic>Patients</topic><topic>People and Places</topic><topic>Pituitary (anterior)</topic><topic>Populations</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Pregnancy Rate</topic><topic>Prevention</topic><topic>Protocol (computers)</topic><topic>Reproduction</topic><topic>Reproductive Control Agents - administration & dosage</topic><topic>Reproductive Control Agents - therapeutic use</topic><topic>Reproductive health</topic><topic>Reproductive technologies</topic><topic>Retrieval</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Sperm</topic><topic>Sperm Injections, Intracytoplasmic</topic><topic>Stem cells</topic><topic>Stimulation</topic><topic>Vascular endothelial growth factor</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gunnala, Vinay</creatorcontrib><creatorcontrib>Melnick, Alexis</creatorcontrib><creatorcontrib>Irani, Mohamad</creatorcontrib><creatorcontrib>Reichman, David</creatorcontrib><creatorcontrib>Schattman, Glenn</creatorcontrib><creatorcontrib>Davis, Owen</creatorcontrib><creatorcontrib>Rosenwaks, Zev</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gunnala, Vinay</au><au>Melnick, Alexis</au><au>Irani, Mohamad</au><au>Reichman, David</au><au>Schattman, Glenn</au><au>Davis, Owen</au><au>Rosenwaks, Zev</au><au>Zenclussen, Ana Claudia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sliding scale HCG trigger yields equivalent pregnancy outcomes and reduces ovarian hyperstimulation syndrome: Analysis of 10,427 IVF-ICSI cycles</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-04-25</date><risdate>2017</risdate><volume>12</volume><issue>4</issue><spage>e0176019</spage><epage>e0176019</epage><pages>e0176019-e0176019</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To evaluate pregnancy outcomes and the incidence of ovarian hyperstimulation syndrome (OHSS) using a sliding scale hCG protocol to trigger oocyte maturity and establish a threshold level of serum b-hCG associated with optimal oocyte maturity.
Retrospective cohort.
Academic medical center.
Fresh IVF cycles from 9/2004-12/2011.
10,427 fresh IVF-ICSI cycles met inclusion criteria. hCG was administered according to E2 level at trigger: 10,000IU vs. 5,000IU vs. 4,000IU vs. 3,300IU vs. dual trigger (2mg leuprolide acetate + 1,500IU hCG). Serum absorption of hCG was assessed according to dose and BMI.
Oocyte maturity was analyzed according to post-trigger serum b-hCG. Fertilization, clinical pregnancy, live birth and OHSS rates were examined by hCG trigger dose.
Post-trigger serum b-hCG 20-30, 30-40, and 40-50 mIU/mL was associated with reduced oocyte maturity as compared b-hCG >50 (67.8% vs. 71.4% vs. 73.3% vs. 78.9%, respectively, P<0.05). b-hCG 20-50 mIU/mL was associated with a 40.1% reduction in live birth (OR 0.59, 95% CI 0.41-0.87). No differences in IVF outcomes per retrieval were seen for varying doses of hCG or dual trigger when controlling for patient age. The incidence of moderate to severe OHSS was 0.13% (n = 14) and severe OHSS was 0.03% (n = 4) of cycles.
Moderate stimulation with sliding scale hCG at trigger and fresh transfer is associated with low rates of OHSS and favorable pregnancy rates. Doses as low as 3,300IU alone or dual trigger with 1,500IU are sufficient to facilitate oocyte maturity.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28441461</pmid><doi>10.1371/journal.pone.0176019</doi><tpages>e0176019</tpages><orcidid>https://orcid.org/0000-0003-4231-6989</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2017-04, Vol.12 (4), p.e0176019-e0176019 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1891907965 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | 17β-Estradiol Abortion Adult Analysis Antagonists Biology Biology and Life Sciences Chorionic gonadotropin Chorionic Gonadotropin - administration & dosage Chorionic Gonadotropin - therapeutic use Chorionic gonadotropins Coasting Cohen, Claudia Computer programs Conferences Criteria Cryopreservation Diagnosis Dosage and administration Drug dosages Embryo transfer Embryos Estrogen receptors Female Fertilization Fertilization in Vitro Follicle-stimulating hormone Follicles Freeze thaw cycles Freeze-thawing Genetic screening Gonadotropin-releasing hormone Gonadotropins Gynecology Health aspects Humans In vitro fertilization In vitro methods and tests Incidence Infertility Leuprolide Maturity Medicine Medicine and Health Sciences Methods Middle Aged Molecular biology Obstetrics Ovarian Hyperstimulation Syndrome - epidemiology Ovarian Hyperstimulation Syndrome - prevention & control Ovulation Induction - adverse effects Ovulation Induction - methods Patients People and Places Pituitary (anterior) Populations Pregnancy Pregnancy Outcome Pregnancy Rate Prevention Protocol (computers) Reproduction Reproductive Control Agents - administration & dosage Reproductive Control Agents - therapeutic use Reproductive health Reproductive technologies Retrieval Retrospective Studies Risk factors Sperm Sperm Injections, Intracytoplasmic Stem cells Stimulation Vascular endothelial growth factor |
| title | Sliding scale HCG trigger yields equivalent pregnancy outcomes and reduces ovarian hyperstimulation syndrome: Analysis of 10,427 IVF-ICSI cycles |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-18T11%3A36%3A37IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Sliding%20scale%20HCG%20trigger%20yields%20equivalent%20pregnancy%20outcomes%20and%20reduces%20ovarian%20hyperstimulation%20syndrome:%20Analysis%20of%2010,427%20IVF-ICSI%20cycles&rft.jtitle=PloS%20one&rft.au=Gunnala,%20Vinay&rft.date=2017-04-25&rft.volume=12&rft.issue=4&rft.spage=e0176019&rft.epage=e0176019&rft.pages=e0176019-e0176019&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0176019&rft_dat=%3Cgale_plos_%3EA493764902%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1891907965&rft_id=info:pmid/28441461&rft_galeid=A493764902&rft_doaj_id=oai_doaj_org_article_22dad90e1c714b11b0bea3ae842ab463&rfr_iscdi=true |