Endocrine Requirements for Oocyte Maturation Following hCG, GnRH Agonist, and Kisspeptin During IVF Treatment

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  • Ali Abbara, Imperial College London
  • ,
  • Tia Hunjan, Imperial College London
  • ,
  • Vu N.A. Ho, My Duc Hospital
  • ,
  • Sophie A. Clarke, Imperial College London
  • ,
  • Alexander N. Comninos, Imperial College London
  • ,
  • Chioma Izzi-Engbeaya, Imperial College London
  • ,
  • Tuong M. Ho, My Duc Hospital
  • ,
  • Geoffrey H. Trew, Imperial College London
  • ,
  • Artsiom Hramyka, University of St Andrews
  • ,
  • Tom Kelsey, University of St Andrews
  • ,
  • Rehan Salim, Imperial College London
  • ,
  • Peter Humaidan
  • Lan N. Vuong, My Duc Hospital, University of Medicine and Pharmacy at Ho Chi Minh City
  • ,
  • Waljit S. Dhillo, Imperial College London

Objective: The maturation of oocytes to acquire competence for fertilization is critical to the success of in vitro fertilization (IVF) treatment. It requires LH-like exposure, provided by either human chorionic gonadotropin (hCG), or gonadotropin releasing hormone agonist (GnRHa). More recently, the hypothalamic stimulator, kisspeptin, was used to mature oocytes. Herein, we examine the relationship between the endocrine changes following these agents and oocyte maturation. Design: Retrospective cohort study. Methods: Prospectively collected hormonal data from 499 research IVF cycles triggered with either hCG, GnRHa, or kisspeptin were evaluated. Results: HCG-levels (121 iU/L) peaked at 24 h following hCG, whereas LH-levels peaked at ~4 h following GnRHa (140 iU/L), or kisspeptin (41 iU/L). HCG-levels were negatively associated with body-weight, whereas LH rises following GnRHa and kisspeptin were positively predicted by pre-trigger LH values. The odds of achieving the median mature oocyte yield for each trigger were increased by hCG/LH level. Progesterone rise during oocyte maturation occurred precipitously following each trigger and strongly predicted the number of mature oocytes retrieved. Progesterone rise was positively associated with the hCG-level following hCG trigger, but negatively with LH rise following all three triggers. The rise in progesterone per mature oocyte at 12 h was greater following GnRHa than following hCG or kisspeptin triggers. Conclusion: The endocrine response during oocyte maturation significantly differed by each trigger. Counter-intuitively, progesterone rise during oocyte maturation was negatively associated with LH rise, even when accounting for the number of mature oocytes retrieved. These data expand our understanding of the endocrine changes during oocyte maturation and inform the design of future precision-triggering protocols.

OriginalsprogEngelsk
Artikelnummer537205
TidsskriftFrontiers in Endocrinology
Vol/bind11
ISSN1664-2392
DOI
StatusUdgivet - okt. 2020

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