3rd Department Ob-Gyn, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Assisting Nature, Center of Reproduction & Genetics, Thessaloniki, Greece.
JBRA Assist Reprod. 2020 Oct 6;24(4):436-441. doi: 10.5935/1518-0557.20200033.
In order to help make the dream of parenthood come true for oocyte acceptors, it is essential that the procedure is not dangerous or unpleasant for oocyte donors. The aim of this study was to identify differences in safety, efficacy and patient acceptability between a traditional stimulation antagonist protocol with recombinant-FSH (rFSH) with hCG-triggering, compared with an innovative antagonist protocol with corifollitropin alfa (Elonva®) plus GnRH agonist triggering in oocyte donors.
A prospective longitudinal study was conducted at an in vitro fertilization center in Greece. The same eighty donors underwent two consecutive antagonist stimulation schemes. Primary outcomes were patient satisfaction (scored by a questionnaire) and delivery rate per donor. Secondary outcomes were mean number of cumulus-oocyte-complexes, metaphase II (MII) oocytes and ovarian hyperstimulation syndrome (OHSS) rate.
Donors reported better adherence and less discomfort with the corifollitropin alpha + GnRH agonist-triggering protocol (p<0.001). No significant differences were identified in the clinical pregnancy rate per donor (p=0.13), the delivery rates, the number of oocytes (p=0.35), the number of MII oocytes (p=0.50) and the number of transferred embryos, between the two protocols. However, the luteal phase duration was significantly shorter (p<0.001) in the corifollitropin alpha + GnRH agonist-triggering protocol. Moreover, three cases of moderate OHSS (3.75%) were identified after hCG triggering, whereas no case of OHSS occurred after GnRH agonist ovulation induction (p=0.25).
The use of corifollitropin alpha combined with a GnRH agonist for triggering is a safe, effective and acceptable protocol for oocyte donors.
为了帮助卵母细胞接受者实现生育梦想,确保卵母细胞供者的过程既无危险又无不适至关重要。本研究旨在比较重组卵泡刺激素(rFSH)联合人绒毛膜促性腺激素(hCG)触发的传统拮抗剂方案与新型促卵泡素释放激素(GnRH)激动剂联合 Corifollitropin Alfa(Elonva®)触发的拮抗剂方案在卵母细胞供者中的安全性、有效性和患者可接受性方面的差异。
一项前瞻性纵向研究在希腊的一家体外受精中心进行。八十名供者连续进行了两次拮抗剂刺激方案。主要结局是患者满意度(通过问卷评分)和每位供者的分娩率。次要结局是平均获卵数、成熟卵母细胞(MII 卵)数和卵巢过度刺激综合征(OHSS)发生率。
与 Corifollitropin Alfa + GnRH 激动剂触发方案相比,供者报告说对 Corifollitropin Alfa + GnRH 激动剂触发方案的依从性更好,不适感更轻(p<0.001)。两种方案的每位供者的临床妊娠率(p=0.13)、分娩率、获卵数(p=0.35)、MII 卵数(p=0.50)和移植胚胎数均无显著差异。然而,Corifollitropin Alfa + GnRH 激动剂触发方案的黄体期持续时间明显缩短(p<0.001)。此外,在 hCG 触发后发现 3 例中度 OHSS(3.75%),而 GnRH 激动剂排卵诱导后未发生 OHSS 病例(p=0.25)。
Corifollitropin Alfa 联合 GnRH 激动剂触发用于卵母细胞供者是一种安全、有效且可接受的方案。