Evaluation of the safety and efficacy of corifollitropin alfa combined with gnrh agonist triggering in oocyte donation cycles. A prospective longitudinal study

Abstract

Objective: In order to help make the dream of par-enthood come true for oocyte acceptors, it is essential that the procedure is not dangerous or unpleasant for oocyte donors. The aim of this study was to identify differenc-es in safety, efficacy and patient acceptability between a traditional stimulation antagonist protocol with recom-binant-FSH (rFSH) with hCG-triggering, compared with an innovative antagonist protocol with corifollitropin alfa (Elonva®) plus GnRH agonist triggering in oocyte donors. Methods: A prospective longitudinal study was con-ducted at an in vitro fertilization center in Greece. The same eighty donors underwent two consecutive antagonist stimulation schemes. Primary outcomes were patient satisfaction (scored by a questionnaire) and delivery rate per donor. Secondary outcomes were mean number of cu-mulus-oocyte-complexes, metaphase II (MII) oocytes and ovarian hyperstimulation syndrome (OHSS) rate. Results: Donors reported better adherence and less discomfort with the corifollitropin alpha + GnRH ago-nist-triggering protocol (p<0.001). No significant differ-ences were identified in the clinical pregnancy rate per donor (p=0.13), the delivery rates, the number of oocytes (p=0.35), the number of MII oocytes (p=0.50) and the number of transferred embryos, between the two proto-cols. However, the luteal phase duration was significantly shorter (p<0.001) in the corifollitropin alpha + GnRH ago-nist-triggering protocol. Moreover, three cases of moderate OHSS (3.75%) were identified after hCG triggering, where-as no case of OHSS occurred after GnRH agonist ovulation induction (p=0.25). Conclusion: The use of corifollitropin alpha combined with a GnRH agonist for triggering is a safe, effective and acceptable protocol for oocyte donors.