Endocrine requirements for oocyte maturation following hCG, GnRH agonist and kisspeptin during IVF treatment
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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.
Abbara , A , Hunjan , T , Ho , V N A , Clarke , S A , Comninos , A N , Izzi-Engbeaya , C , Ho , T M , Trew , G H , Hramyka , A , Kelsey , T , Salim , R , Humaidan , P , Vuong , L N & Dhillo , W S 2020 , ' Endocrine requirements for oocyte maturation following hCG, GnRH agonist and kisspeptin during IVF treatment ' , Frontiers in Endocrinology , vol. 11 , 537205 . https://doi.org/10.3389/fendo.2020.537205
Frontiers in Endocrinology
Copyright © 2020 Abbara, Hunjan, Ho, Clarke, Comninos, Izzi-Engbeaya, Ho, Trew, Hramyka, Kelsey, Salim, Humaidan, Vuong and Dhillo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
DescriptionFunding: The Section of Endocrinology and Investigative Medicine is funded by grants from the MRC, BBSRC, NIHR, an Integrative Mammalian Biology (IMB) Capacity Building Award, an FP7-HEALTH-2009-241592 EuroCHIP grant and is supported by the NIHR Biomedical Research Centre Funding Scheme. Data from trials of GnRH agonist/hCG data were funded by My Duc Hospital, Ho Chi Minh City, Vietnam. AA is funded by an NIHR Clinician Scientist Award (CS-2018-18-ST2-002). CI-E is funded by an MRC Clinical Research Training Fellowship (MR/M004171/1). TK is supported by EPSRC EP/P015638/1. WD is funded by an NIHR Professorship (CDF-2009-02-05) and MRC grant (G1000455).
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