Double dose of kisspeptin-54 improves oocyte yield in women at high risk of OHSS
A second dose of kisspeptin-54 improves oocyte yield in women at high risk of ovarian hyperstimulation syndrome (OHSS) during in vitro fertilization (IVF) treatment, according to a recent study.
“[A] second dose of kisspeptin-54 is a safe option in patients undergoing IVF treatment to further optimize oocyte maturation, even those at high risk of OHSS,” said the researchers. “Further studies are warranted to directly compare kisspeptin-54 to more established triggers of oocyte maturation.”
Sixty-two women with intact ovaries (aged 18–34 years, median body mass index 18–29 kg/m2) undergoing a single IVF cycle received kisspeptin-54 (9.6 nmol/kg) injected subcutaneously at 36 hours prior to oocyte retrieval. Patients were randomized in a 1:1 ratio to a single dose or double dose of kisspeptin-54, the latter administered 10 hours after the first dose to trigger oocyte maturation.
More women in the double-dose group achieved an oocyte yield of ≥60 percent than those in the single-dose group (71 percent [n=22] vs 45.2 percent [n=14]; difference, 25.8 percent, 95 percent confidence interval, 2.1–49.5 percent; p=0.042). [Hum Reprod 2017;32:1915-1924]
Implantation rates were significantly higher in women who received a double dose of kisspeptin-54 than a single dose (37 percent vs 23.3 percent). Live birth rates were also higher with double dose vs single dose of kisspeptin-54 (39 percent vs 19.4 percent).
The oocyte maturation rate was 82 percent for both treatment groups, where all patients in the double-dose group had at least one mature oocyte that was retrieved and fertilized to form an embryo for transfer.
One woman in the single-dose group had an unexplained miscarriage during the second trimester of pregnancy (19 weeks of gestation).
There was no difference in the incidence of OHSS between the two groups. One woman in the single-dose group was diagnosed with moderate, early OHSS, and one woman in the double-dose group had mild, late OHSS.“Despite the study population being at high risk of developing OHSS, a second dose of kisspeptin-54 did not increase the occurrence of excessive ovarian response or OHSS,” noted the researchers.