Kol Shahar
IVF Unit, Elisha Hospital, Haifa,
Gynecol Obstet Invest. 2019;84(1):1-5. doi: 10.1159/000491088. Epub 2018 Jul 13.
Gonadotropin-releasing hormone (GnRH) antagonist-based ovarian stimulation protocol is gaining popularity. This protocol allows for the use of GnRH agonist as a trigger of final oocyte maturation, instead of the "gold standard" human chorionic gonadotropin (hCG) trigger. GnRH agonist trigger causes quick luteolysis, hence its widespread use in the context of ovarian hyperstimulation syndrome (OHSS) prevention. To secure pregnancy post GnRH agonist trigger, the luteal phase must be supplemented to counteract the luteolysis. Several luteal phase protocols post GnRH agonist trigger have been suggested, most notably based on increasing luteal luteinizing hormone (LH) activity (by adding LH or hCG). The current review aims at delineating a rationale for timing luteal support with a single hCG bolus post GnRH agonist trigger. The review also suggests a set of simple rules that must be followed when designing luteal phase support post GnRH agonist trigger.
基于促性腺激素释放激素（GnRH）拮抗剂的卵巢刺激方案正日益受到欢迎。该方案允许使用GnRH激动剂作为最终卵母细胞成熟的触发剂，而不是“金标准”人绒毛膜促性腺激素（hCG）触发剂。GnRH激动剂触发会导致快速黄体溶解，因此其在预防卵巢过度刺激综合征（OHSS）的背景下被广泛使用。为了在GnRH激动剂触发后确保妊娠，必须补充黄体期以抵消黄体溶解。已经提出了几种GnRH激动剂触发后的黄体期方案，最显著的是基于增加黄体期促黄体生成素（LH）活性（通过添加LH或hCG）。本综述旨在阐述在GnRH激动剂触发后用单次hCG推注进行黄体支持的时机的基本原理。该综述还提出了一组在设计GnRH激动剂触发后的黄体期支持时必须遵循的简单规则。
