Ovulatory-cycle frozen embryo transfer: spontaneous or triggered ovulation and the impact of LH elevation at hCG triggering

• Published in: Scientific reports Vol. 13; no. 1; p. 7195
• Main Authors: Bilgory, Asaf, Atzmon, Yuval, Aslih, Nardin, Shibli Abu Raya, Yasmin, Sharqawi, Moamina, Shavit, Maya, Estrada, Daniela, Shalom-Paz, Einat
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 03.05.2023; Nature Publishing Group; Nature Portfolio
• Subjects: 692/308; 692/700; Birth rate; Chorionic Gonadotropin; Cryopreservation - methods; Embryo transfer; Embryo Transfer - methods; Embryos; Female; Gonadotropins; Humanities and Social Sciences; Humans; Luteinizing Hormone; multidisciplinary; Ovulation; Pituitary (anterior); Pregnancy; Pregnancy Rate; Retrospective Studies; Science; Science (multidisciplinary)
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-023-34017-x

The effect of the luteinizing hormone (LH) elevation before the human chorionic gonadotropin (hCG) trigger in ovulatory frozen-thawed embryo transfer (Ovu-FET) cycles has not been determined. We aimed to investigate whether triggering ovulation in Ovu-FET cycles affects the live birth rate (LBR), and the contribution of elevated LH at the time of hCG trigger . This retrospective study included Ovu-FET cycles performed in our center from August 2016 to April 2021. Modified Ovu-FET (hCG trigger) and true Ovu-FET (without hCG trigger) were compared. The modified group was divided according to whether hCG was administered, before or after LH increased to > 15 IU/L and was twice the baseline value. The modified (n = 100) and true (n = 246) Ovu-FET groups and both subgroups of the modified Ovu-FET, those who were triggered before (n = 67) or after (n = 33) LH elevation, had comparable characteristics at baseline. Comparison of true vs. modified Ovu-FET outcomes revealed similar LBR (35.4% vs. 32.0%; P = 0.62), respectively. LBR were similar between the modified Ovu-FET subgroups regardless of the hCG trigger timing (31.3% before vs. 33.3% after LH elevation; P = 0.84). In conclusion, LBR of Ovu-FET were not affected by hCG trigger or whether LH was elevated at the time of hCG trigger. These results add reassurance regarding hCG triggering even after LH elevation.