Tesis doctoral de Daniel Bodri
Background: since its first description in 1984 the indications of oocyte donation (od) has widened considerably which has led to a continuous increase in the number of od treatment cycles performed worldwide. Although this treatment option secured the highest pregnancy rates for the recipients of donor oocytes increased efforts were also made to achieve safer and simpler treament protocols for the oocyte donor. During the last decade with the advent and increased use of the gnrh antagonists this new pharmacological agent was also explored in ovarian stimulation protocols specifically tailored for oocyte donors. materials: the present doctoral thesis summarizes the findings of two recently published articles (2010) on the application of gnrh antagonists in the ovarian stimulation of oocyte donors. Furthermore the findings of another four strictly related articles (published in high-impact international journals between 2006 and 2009) are also discussed. The primary objectives were: 1. To compare efficiency of gnrh antagonist protocols in comparison with gnrh agonist-based protocols in the context of oocyte donation by means of a systematic review and meta-analysis and 2. To illustrate that gnrh antagonist protocols substantially increase the safety of ovarian stimulation for oocyte donors by reducing or even eliminating the incidence of moderate/severe ovarian hyperstimulation syndrome (ohss). results: 1. A meta-analysis of eight randomized clinical trials (rcts) performed in oocyte donors undergoing stimulation with gnrh antagonists showed no significant difference in the number of retrieved oocytes or recipient ongoing pregnancy rate when compared with gnrh agonists. 2. A prospective, follow-up study of a group of high risk oocyte donors showed that early onset moderate/severe ohss was completely eliminated after triggering with a gnrh agonist. Furthermore the findings of four studies supporting the above conclusions are also presented. conclusions: in the context of oocyte donation the gnrh antagonist based ovarian stimulation protocols are equally efficient compared to down regulation by gnrh agonists. The induction of final oocyte maturation can be successfully achieved by a gnrh agonist instead of hcg which practically eliminates early-onset moderate/severe ohss. The proposed ovarian stimulation protocol should be preferentially used because it permits the simplification and considerably increases the safety of ovarian stimulation for oocyte donors.
Datos académicos de la tesis doctoral «Gnrh antagonists in oocyte donor cycles: the key to safe, simple and efficient stimulation protocols«
- Título de la tesis: Gnrh antagonists in oocyte donor cycles: the key to safe, simple and efficient stimulation protocols
- Autor: Daniel Bodri
- Universidad: Autónoma de barcelona
- Fecha de lectura de la tesis: 12/01/2011
Dirección y tribunal
- Director de la tesis
- Joaquim Calaf Alsina
- Tribunal
- Presidente del tribunal: pedro Viscasillas molins
- francisca Martínez (vocal)
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- (vocal)