Objective: To assess the efficacy and safety of gonadotropin releasing hormone agonist (GnRHa) as an alternative to conventional human chorionic gonadotropin (HCG) for triggering of ovulation in patients with polycystic ovarian syndrome (PCOS) undergoing sequential minimal ovarian stimulation followed timed intercourse.
Methods: A randomized controlled study that was conducted on PCOS patients subjected to sequential minimal ovarian stimulation followed by timed intercourse. All participants were randomly allocated at time of triggering of ovulation into 2 groups; GnRHa group in which ovulation was triggered by single SC injection of 0.2 mg of triptorelin, and HCG group in which ovulation was triggered by single IM injection of 5000 IU of urinary HCG. The main study's outcome measures included ovulation rate, clinical pregnancy rate and incidence of early ovarian hyperstimulation syndrome (OHSS).
Results: Final analysis was performed for data of 47 participants in the GnRHa group and 46 participants in the HCG group. There was no significant difference between the GnRHa and the HCG groups in the ovulation rate (95.7% vs 93.5%; P = 0.628) and clinical pregnancy rate (23.4% vs 21.7%; P = 0.848). There was no cases of OHSS in the GnRHa group and just one case in the HCG group, with no significant difference in the incidence of OHSS between the 2 groups (P = 0.495).
Conclusion: The GnRHa could be an effective and safe alternative to the traditional HCG in ovulation triggering after sequential minimal ovarian stimulation in PCOS patients without affecting ovulation and clinical pregnancy rates.