Research question

Does the time interval between the last gonadotrophin-releasing hormone (GnRH) antagonist dose and the GnRH agonist trigger affect the efficacy of the trigger in IVF treatments?

Design

This retrospective cohort study involved 53 normogonadotrophic patients undergoing GnRH antagonist-based IVF cycles, in a single academic centre between June 2019 and February 2020, in whom a GnRH agonist was used for final ovulation triggering.

Results

The mean time interval between the last GnRH antagonist dose and GnRH agonist triggering was 4.6 ± 2.7 h (range 1–12 h). There was no correlation between the antagonist–agonist interval and the oocyte recovery rate (Spearman's correlation coefficient [CC] 0.02, P = 0.89) or metaphase II oocyte rate (CC 0.006, P = 0.96). On multivariate analysis, the antagonist–agonist interval was not associated with treatment outcomes, after adjusting for the women's age and body mass index.

Conclusions

This is the first study assessing the efficacy of the GnRH agonist trigger in relation to the time interval between the last GnRH antagonist dose and the agonist trigger within the first half-life of the GnRH antagonist and in less than 12 h. In normogonadotrophic patients, a GnRH agonist trigger can successfully induce an effective LH surge and oocyte maturation and release, irrespective of the time interval between the last antagonist dose and the agonist trigger. Once confirmed by randomized clinical trials, these finding may simplify treatment, improve patients’ convenience and promote patient adherence to treatment.

中文翻译：

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最后一次 GnRH 拮抗剂剂量和 GnRH 激动剂触发之间的间隔是否会影响卵母细胞的恢复和成熟率？

研究问题

最后一次促性腺激素释放激素 (GnRH) 拮抗剂剂量与 GnRH 激动剂触发剂之间的时间间隔是否会影响触发剂在 IVF 治疗中的功效？

设计

这项回顾性队列研究涉及 2019 年 6 月至 2020 年 2 月期间在一个学术中心接受基于 GnRH 拮抗剂的 IVF 周期的 53 名正常促性腺激素患者，其中 GnRH 激动剂用于触发最终排卵。

结果

最后一次 GnRH 拮抗剂剂量和 GnRH 激动剂触发之间的平均时间间隔为 4.6 ± 2.7 小时（范围 1-12 小时）。拮抗剂-激动剂间隔与卵母细胞回收率（Spearman 相关系数 [CC] 0.02，P  = 0.89）或中期 II 卵母细胞率（CC 0.006，P  = 0.96）之间没有相关性。在多变量分析中，在调整女性年龄和体重指数后，拮抗剂-激动剂间隔与治疗结果无关。

结论

这是第一项评估 GnRH 激动剂触发剂的功效与最后一次 GnRH 拮抗剂剂量与 GnRH 拮抗剂第一个半衰期内和不到 12 小时内的激动剂触发剂之间的时间间隔相关的研究。在正常促性腺激素患者中，GnRH 激动剂触发剂可以成功诱导有效的 LH 激增和卵母细胞成熟和释放，无论最后一次拮抗剂剂量和激动剂触发剂之间的时间间隔如何。一旦被随机临床试验证实，这些发现可能会简化治疗，提高患者的便利性，促进患者对治疗的依从性。