Humaidan Peter, Haahr Thor
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Fertility Clinic Skive, Skive Regional Hospital, Skive, Denmark.
F S Rep. 2023 Feb 28;4(2 Suppl):15-19. doi: 10.1016/j.xfre.2023.02.011. eCollection 2023 Jun.
The objective of this invited review is to describe the introduction and development of the GnRH agonist (GnRHa) trigger protocol in modern in vitro fertilization, focusing on ovarian hyperstimulation syndrome (OHSS) prevention and, equally important on the role of GnRHa trigger as an opener of the luteal phase "black box." The GnRHa trigger and freezing of all embryos is the ultimate weapon against OHSS in the OHSS-risk patient. In the non OHSS-risk patient, GnRHa trigger followed by a modified luteal phase support with lutein hormone activity and subsequent fresh embryo transfer results in excellent reproductive outcomes. Thus, the GnRHa trigger has paved the way for a virtually OHSS-free clinic, and equally important is the fact that the early lessons learned from studying the GnRHa trigger opened the "black box" of the luteal phase enabling improved reproductive outcomes in both fresh and frozen embryo transfer cycles.
这篇特邀综述的目的是描述促性腺激素释放激素激动剂（GnRHa）扳机方案在现代体外受精中的引入与发展，重点关注卵巢过度刺激综合征（OHSS）的预防，以及GnRHa扳机作为黄体期“黑匣子”开启者的同样重要的作用。对于有OHSS风险的患者，GnRHa扳机联合所有胚胎冷冻是对抗OHSS的终极武器。对于无OHSS风险的患者，GnRHa扳机后采用具有黄体激素活性的改良黄体期支持并随后进行新鲜胚胎移植可带来优异的生殖结局。因此，GnRHa扳机为几乎无OHSS的临床实践铺平了道路，同样重要的是，从研究GnRHa扳机中获得的早期经验教训打开了黄体期的“黑匣子”，从而在新鲜和冷冻胚胎移植周期中都能改善生殖结局。
