الفهرس | Only 14 pages are availabe for public view |
Abstract Polycystic ovary syndrome is one of the major causes of infertility. Ovarian hyper stimulation syndrome and multiple pregnancies are known complications of PCOS in ART. Over several decades, human chorionic gonadotropin (hCG) has been the gold standard for ovulation triggering as a surrogate for the mid cyclic LH surge. Because of their structural and biological similarities, both hCG and LH can bind to and excite the same receptor. Triggering with a GnRH agonist induces a mid-cycle FSH surge comparable to what occurs in a normal ovulatory cycle, the LH Rs expression is required for luteinization of granulosa cells with the help of for the pre-ovulatory LH surge, FSH is in addition required for the commencing of oocyte meiosis and the augmentation of cumulus cells. Gonadotropin releasing hormone agonist (GnRHa) is now considered safe and efficient for triggering final oocyte maturation not only in ART cycles but also in MOS in women with PCOS. The GnRH agonist could be a safer and effective alternative to hCG in initiating ovulation in PCOS cases for ovulation induction with no impaction of the ovulation rate or CPR. |