212:-derived hCG (uHCG) are equally effective in achieving final follicular maturation in IVF with regards to pregnancy rates and risk of ovarian hyperstimulation syndrome. Therefore, urine-derived hCG (uHCG) is regarded as the best choice for final oocyte maturation triggering in IVF due to availability and cost.
267:
of pregnancy of approximately 0.47. It estimated that, for a woman with a 31% chance of achieving live birth with the use of hCG, the chance of a live birth with the use of an GnRH agonist would be between 12% and 24%. Likewise, using GnRH agonist instead of hCG was associated with a lower ongoing
194:
is then performed at a time usually between 34 and 36 hours after hCG injection, that is, shortly before when the follicles would rupture. A retrieval at 36 hours after final maturation induction appears to result in optimal embryo quality and pregnancy outcomes. HCG injection confers a risk of
128:
tests. Therefore, in such cases, triggering oocyte release is best reserved for women who require IUI and in whom LH monitoring proves difficult or unreliable. It may also be used when LH monitoring hasn't shown an LH surge by cycle day 18 (where cycle day 1 is the first day of the preceding
104:
Administration of a drug to trigger oocyte release without oocyte retrieval results in a predictable time of ovulation, with the interval from drug administration to ovulation depending on the type of drug. This avails for
163:
of at least 15 mm, and serum estradiol level of 0.49 nmol/L before commencing final maturation induction. There are better prospects at a follicle size of 18 mm and serum estradiol level of 0.91 nmol/L.
247:
of approximately 0.15. The review estimated that, for a woman with a 5% risk of mild, moderate or severe OHSS with the use of HCG, the risk of OHSS with the use of a GnRH agonist would be between 0 and 2%.
354:
Youssef, Mohamed AFM; Van der Veen, Fulco; Al-Inany, Hesham G; Mochtar, Monique H; Griesinger, Georg; Nagi
Mohesen, Mohamed; Aboulfoutouh, Ismail; van Wely, Madelon; Youssef, Mohamed AFM (2014).
642:
567:
124:
for intended conception by sexual intercourse, however, triggering oocyte release has been shown to decrease pregnancy chances compared to frequent monitoring with
403:
101:
to induce final maturation is colloquially called giving a "trigger shot", even if the plan is to perform artificial oocyte retrieval before ovulation.
77:, use of GnRH agonists instead of hCG decreases the risk of ovarian hyperstimulation syndrome with no evidence of a difference in live birth rate.
226:, because using GnRH agonist for that purpose as well inactivates the axis for which it is intended to work for final maturation induction.
595:"A 38 h interval between hCG priming and oocyte retrieval increases in vivo and in vitro oocyte maturation rate in programmed IVM cycles"
223:
156:
24:
776:
268:
pregnancy rate (pregnancy beyond 12 weeks) than was seen with HCG (odds ratio 0.70) and a higher rate of early (less than 12 weeks)
236:
196:
66:
179:(HCG or hCG) in a low dose, which may be injected after completed ovarian stimulation. Final maturation with hCG is also termed
493:
191:
356:"Gonadotropin-releasing hormone agonist versus HCG for oocyte triggering in antagonist-assisted reproductive technology"
176:
43:
295:, because ovarian hyperstimulation syndrome is associated with an increased risk of arterial thrombotic events such as
781:
243:
estimated that using GnRH agonist instead of hCG in IVF decreases the risk of mild, moderate or severe OHSS with an
500:. By Robert B. McWilliams. The Center for Reproduction and Women's Health Care, Houston, Texas. Retrieved May 2014
110:
791:
407:
51:
430:
263:). A Cochrane review of autologous oocyte transfers estimated that GnRH agonist, compared to hCG, gives an
292:
184:
142:
59:
718:"Risk of thrombosis in women with malignancies undergoing ovarian stimulation for fertility preservation"
796:
636:
561:
300:
716:
Somigliana, E.; Peccatori, F. A.; Filippi, F.; Martinelli, F.; Raspagliesi, F.; Martinelli, I. (2014).
272:(odds ratio 1.74). However, a higher pregnancy rate when using hCG is only found in those receiving
786:
277:
256:
205:
117:
98:
55:
32:
771:
528:"The impact of different time intervals between hCG priming and oocyte retrieval on ART outcomes"
311:
106:
183:. Ovulation will occur between 38 and 40 hours after a single HCG injection. It is also used in
291:
Final maturation induction using a GnRH agonist is recommended in women with cancer undergoing
235:
Final maturation induction using GnRH agonist results in a substantial decrease in the risk of
747:
739:
698:
680:
624:
549:
473:
385:
304:
729:
688:
672:
614:
606:
539:
463:
375:
367:
160:
130:
113:(IUI) to conveniently be scheduled at ovulation, the most likely time to achieve pregnancy.
90:
65:, final oocyte maturation triggering with GnRH agonist instead of hCG decreases the risk of
28:
434:
323:
315:
260:
252:
240:
219:
202:
74:
70:
36:
509:
490:
380:
355:
693:
660:
619:
594:
544:
527:
319:
273:
85:
Induction of final maturation also initiates the mechanisms that eventually result in
765:
497:
468:
451:
149:
450:
Practice
Committee of the American Society for Reproductive Medicine (August 2013).
676:
371:
281:
215:
47:
593:
Son WY, Chung JT, Chian RC, Herrero B, Demirtas E, Elizur S; et al. (2008).
513:
269:
89:, and thereby makes the oocytes destined to undergo ovulation unless artificial
264:
244:
743:
684:
580:
734:
717:
610:
285:
121:
93:
is performed first. Therefore, induction of final maturation is also called
86:
751:
702:
628:
553:
477:
389:
307:, and this risk can add to an already increased risk caused by the cancer.
172:
Medications used for final maturation and/or release of oocytes include:
125:
27:
to render the oocytes fully developed and thereby resulting in optimal
296:
20:
314:. Also, no difference has been found between the regimens regarding
661:"Assisted reproductive technology: an overview of Cochrane Reviews"
452:"Use of clomiphene citrate in infertile women: a committee opinion"
526:
Ghasemian F, Faraji R, Asgharnia M, Zahiri Z, Bahadori MH (2013).
209:
190:, where it makes the follicles perform their final maturation. A
427:
42:
The main medications used for induction of final maturation are
581:
HCG Injection After
Ovulation Induction With Clomiphene Citrate
322:
when the controlled ovarian hyperstimulation was followed by
35:(LH) surge whose effects include final maturation in natural
310:
Using hCG versus GnRH agonist has no effect on the risk of
349:
347:
345:
343:
341:
339:
224:
suppression of ovulation during ovarian hyperstimulation
659:
Farquhar, Cindy; Marjoribanks, Jane (17 August 2018).
23:
is a procedure that is usually performed as part of
155:In IVF, final maturation induction is preceded by
159:. It is suggested that there should be a size of
583:at Medscape. By Peter Kovacs. Posted: 04/23/2004
148:(IVF), induction of final maturation avails for
445:
443:
8:
641:: CS1 maint: multiple names: authors list (
566:: CS1 maint: multiple names: authors list (
665:The Cochrane Database of Systematic Reviews
97:from the ovary, and the administration of
733:
692:
618:
543:
467:
379:
259:oocyte transfers (rather than ones using
251:However, using GnRH agonist has a lower
31:. It is basically a replacement for the
360:Cochrane Database of Systematic Reviews
335:
634:
559:
137:Usage with artificial oocyte retrieval
654:
652:
7:
157:controlled ovarian hyperstimulation
25:controlled ovarian hyperstimulation
208:(rLH), recombinant HCG (rHCG) and
14:
237:ovarian hyperstimulation syndrome
197:ovarian hyperstimulation syndrome
67:ovarian hyperstimulation syndrome
469:10.1016/j.fertnstert.2013.05.033
428:IVF.com > Ovulation Induction
152:when the eggs are fully mature.
677:10.1002/14651858.CD010537.pub5
372:10.1002/14651858.CD008046.pub4
129:menstruation) and there is an
1:
218:, which necessitates using a
192:transvaginal oocyte retrieval
17:Induction of final maturation
177:Human chorionic gonadotropin
133:of over 20 mm in size.
44:human chorionic gonadotropin
813:
516:. By Dr Praveen Jha et al.
491:Clomiphene Citrate, Clomid
777:Female genital procedures
722:Human Reproduction Update
437:Retrieved on Mars 7, 2010
111:intrauterine insemination
95:triggering oocyte release
73:. In cycles followed by
50:. In fresh (rather than
255:than when using hCG in
231:HCG versus GnRH agonist
293:fertility preservation
735:10.1093/humupd/dmu035
611:10.1093/humrep/den210
510:Follicular monitoring
301:myocardial infarction
99:pharmaceutical drugs
81:Usage with ovulation
278:luteinizing hormone
206:luteinizing hormone
118:ovulation induction
33:luteinizing hormone
782:Fertility medicine
433:2012-02-26 at the
312:multiple pregnancy
280:activity (such as
107:sexual intercourse
532:Iran J Reprod Med
305:arterial embolism
161:ovarian follicles
29:pregnancy chances
804:
756:
755:
737:
713:
707:
706:
696:
656:
647:
646:
640:
632:
622:
590:
584:
578:
572:
571:
565:
557:
547:
523:
517:
507:
501:
488:
482:
481:
471:
447:
438:
425:
419:
418:
416:
415:
406:. Archived from
400:
394:
393:
383:
366:(10): CD008046.
351:
131:ovarian follicle
91:oocyte retrieval
37:menstrual cycles
812:
811:
807:
806:
805:
803:
802:
801:
792:Human pregnancy
762:
761:
760:
759:
715:
714:
710:
671:(8): CD010537.
658:
657:
650:
633:
592:
591:
587:
579:
575:
558:
525:
524:
520:
508:
504:
489:
485:
449:
448:
441:
435:Wayback Machine
426:
422:
413:
411:
402:
401:
397:
353:
352:
337:
332:
324:oocyte donation
316:live birth rate
303:and peripheral
261:oocyte donation
253:live birth rate
241:Cochrane review
233:
220:GnRH antagonist
170:
139:
83:
75:oocyte donation
71:live birth rate
12:
11:
5:
810:
808:
800:
799:
794:
789:
784:
779:
774:
764:
763:
758:
757:
728:(6): 944–951.
708:
648:
585:
573:
518:
502:
496:2014-05-10 at
483:
456:Fertil. Steril
439:
420:
395:
334:
333:
331:
328:
320:pregnancy rate
274:luteal support
232:
229:
228:
227:
213:
200:
169:
166:
138:
135:
82:
79:
69:but decreases
13:
10:
9:
6:
4:
3:
2:
809:
798:
795:
793:
790:
788:
785:
783:
780:
778:
775:
773:
770:
769:
767:
753:
749:
745:
741:
736:
731:
727:
723:
719:
712:
709:
704:
700:
695:
690:
686:
682:
678:
674:
670:
666:
662:
655:
653:
649:
644:
638:
630:
626:
621:
616:
612:
608:
605:(9): 2010–6.
604:
600:
596:
589:
586:
582:
577:
574:
569:
563:
555:
551:
546:
541:
538:(7): 559–64.
537:
533:
529:
522:
519:
515:
511:
506:
503:
499:
498:archive.today
495:
492:
487:
484:
479:
475:
470:
465:
461:
457:
453:
446:
444:
440:
436:
432:
429:
424:
421:
410:on 2012-11-18
409:
405:
399:
396:
391:
387:
382:
377:
373:
369:
365:
361:
357:
350:
348:
346:
344:
342:
340:
336:
329:
327:
325:
321:
317:
313:
308:
306:
302:
298:
294:
289:
287:
283:
279:
275:
271:
266:
262:
258:
254:
249:
246:
242:
238:
230:
225:
222:protocol for
221:
217:
214:
211:
207:
204:
201:
198:
193:
189:
188:fertilization
187:
182:
178:
175:
174:
173:
167:
165:
162:
158:
153:
151:
150:egg retrieval
147:
146:fertilization
145:
136:
134:
132:
127:
123:
119:
114:
112:
108:
102:
100:
96:
92:
88:
80:
78:
76:
72:
68:
64:
63:fertilization
62:
57:
53:
49:
45:
40:
38:
34:
30:
26:
22:
18:
797:Reproduction
725:
721:
711:
668:
664:
637:cite journal
602:
598:
588:
576:
562:cite journal
535:
531:
521:
505:
486:
462:(2): 341–8.
459:
455:
423:
412:. Retrieved
408:the original
398:
363:
359:
309:
290:
282:progesterone
250:
234:
216:GnRH agonist
185:
180:
171:
154:
143:
140:
115:
103:
94:
84:
60:
48:GnRH agonist
41:
16:
15:
514:Radiopaedia
404:"About.com"
318:or ongoing
270:miscarriage
203:Recombinant
181:hCG priming
168:Medications
787:Obstetrics
766:Categories
599:Hum Reprod
414:2014-05-10
330:References
265:odds ratio
257:autologous
245:odds ratio
239:(OHSS). A
58:cycles of
56:autologous
46:(hCG) and
772:Fertility
744:1355-4786
685:1469-493X
286:progestin
122:clomifene
87:ovulation
752:25013217
703:30117155
629:18556681
554:24639791
494:Archived
478:23809505
431:Archived
390:25358904
381:10767297
276:without
186:in vitro
144:in vitro
126:LH surge
120:, using
61:in vitro
694:6953328
620:2517153
545:3941349
21:oocytes
750:
742:
701:
691:
683:
627:
617:
552:
542:
476:
388:
378:
297:stroke
52:frozen
512:from
210:urine
748:PMID
740:ISSN
699:PMID
681:ISSN
669:2018
643:link
625:PMID
568:link
550:PMID
474:PMID
386:PMID
364:2014
730:doi
689:PMC
673:doi
615:PMC
607:doi
540:PMC
464:doi
460:100
376:PMC
368:doi
288:).
284:or
141:In
116:In
109:or
19:of
768::
746:.
738:.
726:20
724:.
720:.
697:.
687:.
679:.
667:.
663:.
651:^
639:}}
635:{{
623:.
613:.
603:23
601:.
597:.
564:}}
560:{{
548:.
536:11
534:.
530:.
472:.
458:.
454:.
442:^
384:.
374:.
362:.
358:.
338:^
326:.
299:,
54:)
39:.
754:.
732::
705:.
675::
645:)
631:.
609::
570:)
556:.
480:.
466::
417:.
392:.
370::
199:.
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.