For both hCG and GnRHa, follicle sizes of 12–19 mm had the greatest contributions to the number of oocytes and mature oocytes retrieved (see Table 2). Your doctor will monitor your ovaries via ultrasound and give you the green light to do the trigger shot when your follicles are of a size that your clinic specifies. It is well known that oocyte maturity is linked with follicle size 1. Hum Reprod (2010) 25(5):1219–24. However, while it is possible to speculate that kisspeptin could enhance oocyte maturation in combination with gonadotropin exposure, it is unlikely that in vivo administration can lead to oocyte maturation in the absence of a gonadotropin-response (9). A prospective randomized study of the optimum timing of human chorionic gonadotropin administration after pituitary desensitization in in vitro fertilization. Our model predicts that the number of oocytes retrieved from patients with 20 follicles on the day of trigger would increase from a mean of 9.8 (95% prediction limit 9.3–10.3) to 14.8 (95% prediction limit 13.3–16.3) oocytes due to the difference in follicle size profile alone (P < 0.001). Follies grow 2 mm a day. Collectively, data from both animal models and humans have demonstrated that exogenous kisspeptin administration stimulates endogenous GnRH release from the hypothalamus (7). Reply Quote. Fertil Steril (2007) 88(1):237–9. doi:10.1007/s10815-010-9527-z, 36. A quantitative assessment of follicle size on oocyte developmental competence. Clarke SA, Dhillo WS. That it's either a cycst (which I'm pretty sure it's not) or the egg is "over mature"?? Furthermore, delaying triggering until follicles grow to a larger size could also result in an untimely rise in serum progesterone that could prematurely mature the endometrium, resulting in an out of phase endometrium and reduced implantation rates (26). Exclusion criteria: moderate/severe endometriosis, poor ovarian response in a former IVF cycle [previous poor response (≤3 oocytes retrieved on a previous IVF cycle), or ≥2 previous IVF treatment cycles]. They reported mature oocyte yields (mature oocytes from follicles of ≥10 mm) of 63% after GnRHa (5). doi:10.1016/j.fertnstert.2011.08.029, 29. including 7 RCTs and 1,295 IVF cycles compared administration of hCG as soon as ≥3 follicles were ≥17 mm in size (“early”) vs administration of hCG either 24 or 48 h later (“late”) (33). Paradoxical effects of kisspeptin: it enhances oocyte in vitro maturation but has an adverse impact on hatched blastocysts during in vitro culture. Patients: Four hundred and forty nine women aged 18–38 years with antral follicle counts 4–87 were triggered with hCG (n = 161), GnRHa (n = 165), or kisspeptin (n = 173). Analysis was carried out by AA and TK. Drug-induced immunosuppression in ABD (e.g. Data included in this manuscript were obtained from studies carried out in accordance with the recommendations of the local ethical boards listed below. Although the contribution was small, several studies have suggested that kisspeptin may have additional direct ovarian effects via ovarian kisspeptin receptors, beyond its predominant mode of action via endogenous GnRH release from the hypothalamus (38–41). Further randomized studies are required to determine whether triggering of oocyte maturation once most follicles are within the size range 12–19 mm can lead to improved oocyte yields compared with traditional determination of day of triggering. For the hCG case-series, the IRB reference number was NCKH/CGRH_09_2017, ethical approval reference number: 10/17/DD-BVMD and ClinicalTrials.gov Identifier: NCT03174691. Data included in this manuscript were obtained from studies carried out in accordance with the recommendations of the local ethical boards listed below. All follicles that were visible on ultrasound and ≥8 mm in diameter were aspirated at oocyte retrieval. Here are the most important contributions of each author: AA, LV, RS, TK, GT, PH, and WD designed the study. doi:10.1016/j.rbmo.2017.12.014, 15. Comparison of in-vitro maturation cycles with and without in-vivo matured oocytes retrieved. Fertil Steril (1995) 64(4):787–90. Patients did not receive hCG if there were more than 20 follicles of ≥14 mm on the day of trigger. (2) observed that follicles of 16–23 mm on the day of oocyte retrieval had higher fertilization rates (68%) than either follicles < 16 mm (56%) or those >23 mm (56%) (2). Saadeldin IM, Koo OJ, Kang JT, Kwon DK, Park SJ, Kim SJ, et al. Using the model generated through random forest analysis of patients triggered with hCG or GnRHa, we simulated 1,000 patients having all their follicles within the optimal follicle size range (12–19 mm) and compared these to a further 1,000 simulated patients with all their follicles outside of this size range. 48 hours so they have to be given at a certain time Duffy P, Gangineni a Reddy. Research ( NIHR ) clinical Lectureships rates of ovarian hyperstimulation syndrome following different hormonal triggers of oocyte in... ) are given around 18-20 mm generalized linear model of the study include that is.! Linear model of the most to the number of oocytes and number of high quality.... Say 27mm is too big??????????????... An injection with a body mass index ( BMI ) 18–29 kg/m2 had... Follicles increase beyond a certain size, a trigger is most likely to yield a mature yields. 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