Efficacy of Kisspeptin-54 to Trigger Oocyte Maturation in Women at High Risk of Ovarian Hyperstimulation Syndrome (OHSS) During In Vitro Fertilization (IVF) Therapy
| Autor: | Deborah Ashby, Rehan Salim, Stuart Lavery, Risheka Ratnasabapathy, Gurjinder M. K. Nijher, Deborah Peters, Ali Abbara, Shakunthala Narayanaswamy, Waljit S. Dhillo, Julia K Prague, Matyas Szigeti, Alexander N Comninos, Adam Buckley, Channa N. Jayasena, Stephen R. Bloom, Georgios Christopoulos, Geoffrey Trew, Chioma Izzi-Engbeaya |
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| Rok vydání: | 2015 |
| Předmět: |
Infertility
Adult medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Clinical Biochemistry Ovarian hyperstimulation syndrome Context (language use) Fertilization in Vitro Hormone antagonist Biochemistry Andrology Gonadotropin-Releasing Hormone 03 medical and health sciences Follicle-stimulating hormone Ovarian Hyperstimulation Syndrome 0302 clinical medicine Endocrinology Hormone Antagonists Ovulation Induction Pregnancy Risk Factors medicine Humans 030304 developmental biology Gynecology 0303 health sciences Kisspeptins 030219 obstetrics & reproductive medicine In vitro fertilisation business.industry Biochemistry (medical) Female infertility Original Articles medicine.disease 3. Good health Ovulation induction Drug Therapy Combination Female Follicle Stimulating Hormone business Infertility Female hormones hormone substitutes and hormone antagonists |
| Zdroj: | The Journal of Clinical Endocrinology and Metabolism |
| ISSN: | 1945-7197 |
| Popis: | Context: In vitro fertilization (IVF) treatment is an effective therapy for infertility, but can result in the potentially life-threatening complication, ovarian hyperstimulation syndrome (OHSS). Objective: This study aimed to investigate whether kisspeptin-54 can be used to effectively and safely trigger oocyte maturation in women undergoing IVF treatment at high risk of developing OHSS. Setting and Design: This was a phase 2, multi-dose, open-label, randomized clinical trial of 60 women at high risk of developing OHSS carried out during 2013–2014 at Hammersmith Hospital IVF unit, London, United Kingdom. Intervention: Following a standard recombinant FSH/GnRH antagonist protocol, patients were randomly assigned to receive a single injection of kisspeptin-54 to trigger oocyte maturation using an adaptive design for dose allocation (3.2 nmol/kg, n = 5; 6.4 nmol/kg, n = 20; 9.6 nmol/kg, n = 15; 12.8 nmol/kg, n = 20). Oocytes were retrieved 36 h after kisspeptin-54 administration, assessed for maturation, and fertilized by intracytoplasmic sperm injection with subsequent transfer of one or two embryos. Women were routinely screened for the development of OHSS. Main Outcome Measure: Oocyte maturation was measured by oocyte yield (percentage of mature oocytes retrieved from follicles ≥ 14 mm on ultrasound). Secondary outcomes include rates of OHSS and pregnancy. Results: Oocyte maturation occurred in 95% of women. Highest oocyte yield (121%) was observed following 12.8 nmol/kg kisspeptin-54, which was +69% (confidence interval, −16–153%) greater than following 3.2 nmol/kg. At all doses of kisspeptin-54, biochemical pregnancy, clinical pregnancy, and live birth rates per transfer (n = 51) were 63, 53, and 45%, respectively. Highest pregnancy rates were observed following 9.6 nmol/kg kisspeptin-54 (85, 77, and 62%, respectively). No woman developed moderate, severe, or critical OHSS. Conclusion: Kisspeptin-54 is a promising approach to effectively and safely trigger oocyte maturation in women undergoing IVF treatment at high risk of developing OHSS. |
| Databáze: | OpenAIRE |
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