Does GnRH agonist triggering control painful symptom scores during assisted reproductive technology? a retrospective study
Abstract
Objective The aim of this study was to assess the progression of pain symptoms during assisted reproductive technology (ART) cycles following administration of GnRH agonist (GnRHa) versus human chorionic gonadotrophin (hCG) triggering.Design Observational cohort study.Setting A tertiary care university hospital in France.Population Patients who underwent ART programs.Methods Between January 01, 2014, and June 31, 2014, 122 cycles were allocated to 2 groups: GnRHa triggering with a scheduled differed embryo transfer (n = 57) or hCG triggering with a fresh embryo transfer (n = 70). Pelvic pain scores were evaluated using a visual analog scale (VAS) with regard to dysmenorrhea, dyspareunia, noncyclic pelvic pain, gastrointestinal, and lower urinary tract pain. The total VAS score was defined as the sum of the scores for the various symptoms. Evaluations were carried out twice: during the synchronization treatment prior to ovarian stimulation and during a final evaluation 3 weeks postretrieval. The data were processed using univariate and multivariate logistic regression models.Main outcome measures Trends for total VAS change (ie, final VAS score - synchronization VAS score).Results For both groups, pain increased during the ART procedure. Trends for the total VAS change revealed that the increase in pain was significantly less in the "GnRHa triggering" group compared to the "hCG triggering" group (3.77 ± 7.73 and 6.50 ± 6.57, P < .05, respectively). Multivariate logistic regression indicated that GnRHa triggering was associated with less of an increase in pain compared to hCG triggering (odds ratio = 0.31, 95% confidence interval 0.13-0.71, P < .05).Conclusion Compared to hCG, GnRHa triggering limits pain symptom progression in the period immediately after ART.
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In endometriosis, ovarian stimulation with an antagonist protocol and ovulation triggering with a GnRH agonist did not increase endometriosis-related symptoms.
“In endometriosis, we have reported that ovarian stimulation for ART using an antagonist protocol and triggering of the final step of ovulation with a GnRH-a did not increase endometriosis-related symptoms (56,57).”
From Endometrial receptivity in adenomyosis and/or endometriosis (2023) · cites this paper as [56]
Embryo transfers conducted in estradiol and progesterone cycles may have a beneficial effect on endometrial receptivity.
“Indeed, embryo transfers conducted in E 2 and progesterone cycles may have a beneficial effect on endometrial receptivity.”
From Endometrial receptivity in adenomyosis and/or endometriosis (2023) · cites this paper as [56]
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- Authors
- Bourdon, M., Santulli, P., de Ziegler, D., Gayet, V., Maignien, C., Marcellin, L., & Chapron, C.
- Affiliations
- Sorbonne Paris Cité (FR)
- Inserm (FR)
- Venue
- Reproductive Sciences
- Published
- 2017-09
- Volume
- 24
- Issue
- 9
- Pages
- 1325-1333
- ISSN
- 1933-7191 (ISSN-L)
- 1933-7205
- OpenAlex
- W2571196529
- Cited by
- 15
- References
- 49
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 4 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 1
- FWCI
- 1.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Reproductive Sciences (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Assisted Reproductive Technology and Twin Pregnancy
- Keywords
- GnRH agonist triggering, assisted reproduction, pain symptoms, dysmenorrhea, dyspareunia, gastrointestinal pain, fresh embryo transfer, ovulation induction
- MeSH terms
- Adult, Female, Chorionic Gonadotropin, Humans, Menotropins, Ovulation Induction, Pregnancy, Retrospective Studies, Pelvic Pain, Reproductive Techniques, Assisted
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