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Clinical and Experimental Obstetrics & Gynecology  2017, Vol. 44 Issue (2): 279-282    DOI: 10.12891/ceog3301.2017
Case Report Previous articles | Next articles
GnRH antagonist rescue of a short-protocol IVF/ICSI cycle and GnRH agonist triggering to prevent ovarian hyperstimulation syndrome: two case reports
P. Bakas1, *(), I. Boutas1, M. Giner1, P. Panagopoulos2, L. Aravantinos1
1 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens, Athens, Greece
2 3rd Department of Obstetrics and Gynecology, Attiko Hospital, University of Athens, Athens, Greece
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Abstract  
Objective: To describe two clinical cases concerning patients at risk of developing severe ovarian hyperstimulation syndrome (OHSS) during in vitro fertilization (IVF) stimulation. Design: Description of clinical management and outcomes of patients using an IVF antagonist rescue protocol to prevent OHSS. Setting: Reproductive medicine unit, University Hospital. Materials and Methods: Two infertile patients undergoing controlled ovarian stimulation (COS) for IVF/intracytoplasmic sperm injection (ICSI) presenting with high risk of OHSS. IVF/ICSI patients following COS under short protocol and high risk of OHSS were managed by withdrawing the agonist and replacing it with an antagonist and triggering ovulation with an agonist bolus. Main outcome measures included incidence of OHSS, oocytes retrieved, and pregnancy rates. Results: None of the two patients developed OHSS. None of the patients had metaphase II retrieved oocytes at oocyte retrieval. Conclusions: Use of COS with short protocol in an IVF/ICSI cycle carries a risk of severe OHSS. Rescuing the cycle by withdrawing the agonist and replacing it with an antagonist and triggering ovulation with an agonist bolus is not always effective and should not be used if short time interval between agonist replacement with antagonist and ovulation triggering is available.
Key words:  GnRH antagonist      Rescue      Agonist      Agonist trigger      OHSS      IVF     
Published:  10 April 2017     
*Corresponding Author(s):  P. BAKAS     E-mail:  p_bakas@yahoo.com

Cite this article: 

P. Bakas, I. Boutas, M. Giner, P. Panagopoulos, L. Aravantinos. GnRH antagonist rescue of a short-protocol IVF/ICSI cycle and GnRH agonist triggering to prevent ovarian hyperstimulation syndrome: two case reports. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(2): 279-282.

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https://ceog.imrpress.com/EN/10.12891/ceog3301.2017     OR     https://ceog.imrpress.com/EN/Y2017/V44/I2/279

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