Open AccessThe gonadotropin‐releasing hormone antagonist protocol – the protocol of choice for the polycystic ovary syndrome patient undergoing controlled ovarian stimulation
Author(s) -
KOL SHAHAR,
HOMBURG ROY,
ALSBJERG BIRGIT,
HUMAIDAN PETER
Publication year - 2012
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/j.1600-0412.2012.01399.x
Subject(s) - ovarian hyperstimulation syndrome , medicine , luteal phase , human chorionic gonadotropin , gonadotropin , polycystic ovary , in vitro fertilisation , gonadotropin releasing hormone agonist , endocrinology , hormone antagonist , gonadotropin releasing hormone antagonist , gonadotropin releasing hormone , pregnancy , hormone , luteinizing hormone , biology , insulin , insulin resistance , endocrine system , genetics
Polycystic ovary syndrome (PCOS) patients are prone to develop ovarian hyperstimulation syndrome (OHSS), a condition which can be minimized or completely eliminated by the use of a gonadotropin‐releasing hormone agonist (GnRHa) trigger. In this commentary paper, we maintain that the gonadotropin‐releasing hormone antagonist protocol should be the protocol of choice for the PCOS patient undergoing ovarian stimulation with gonadotropins for in vitro fertilization. If an excessive ovarian response is encountered, the clinician will always have two options: either to trigger final oocyte maturation with a bolus of GnRHa and supplement the luteal phase with a small bolus of human chorionic gonadotropin in addition to the standard luteal phase support and transfer in the fresh cycle or, alternatively, to trigger with GnRHa and perform a total freeze, resulting in a complete elimination of OHSS and high ongoing pregnancy rates in the subsequent frozen–thawed transfer cycles.