Random-start gonadotropin-releasing hormone (GnRH) antagonist-treated cycles with GnRH agonist trigger for fertility preservation

Objective: To describe our experience with random-start IVF with the use of GnRH agonist for final oocyte maturation, to reduce the risk of ovarian hyperstimulation syndrome. Design: Case series. Setting: University-based center for reproductive endocrinology and infertility. Patient(s): Patients with a new diagnosis of cancer who presented with a narrow time frame for IVF before initiating cancer therapy. Intervention(s): Random-start GnRH antagonist cycles with GnRH agonist trigger for final oocyte maturation. Main Outcome Measure(s): Number of oocytes retrieved, fertilization rate, rates of ovarian hyperstimulation syndrome. Results: Cycles were started in the late follicular or luteal phase, and the duration of controlled ovarian hyperstimulation ranged between 8-13 days. A total of 14-40 oocytes were retrieved and 5-20 embryos cryopreserved for each patient. Conclusion(s): Random-start IVF is a reasonable option for fertility preservation in those cancer patients for whom the treatment window may be narrow. In addition, the use of a GnRH agonist for final oocyte maturation may decrease the potential risk of ovarian hyperstimulation syndrome. (Fertil Steril (R) 2011; 96: e51-4. (C) 2011 by American Society for Reproductive Medicine.)