SFEBES2015 Oral Communications Advances in reproduction and signalling (6 abstracts)
Kisspeptin-54 safely and effectively triggers oocyte maturation during IVF treatment in women at high risk of developing ovarian hyperstimulation syndrome (OHSS)
Ali Abbara 1 , Channa Jayasena 1 , Georgios Christopoulos 2 , Shakunthala Narayanaswamy 1 , Chioma Izzi-Engbeaya 1 , Gurjinder Nijher 1 , Alexander Comninos 1 , Deborah Peters 1 , Adam Buckley 1 , Risheka Ratnasabapathy 1 , Julia Prague 1 , Stephen Bloom 1 , Geoffrey Trew 2 & Waljit Dhillo 1
1Imperial College London, London, UK; 2Hammersmith IVF Unit, London, UK.
Context: IVF treatment is an effective therapy for infertility, but can result in the potentially life-threatening complication ‘ovarian hyperstimulation syndrome’ (OHSS).
Objective: To investigate whether kisspeptin-54 can be used to effectively and safely trigger oocyte maturation in women undergoing IVF treatment at high risk of developing OHSS.
Design: Phase 2 multi-dose open label randomised clinical trial.
Setting: Hammersmith Hospital IVF Unit, London, UK.
Patients: Sixty women at high risk of developing OHSS.
Intervention: Following a standard recombinant FSH/GnRH antagonist protocol, patients were randomized to receive a single injection of kisspeptin-54 to trigger oocyte maturation using an adaptive design for dose allocation (3·2 nmol/kg, n=5; 6.4 nmol/kg, n=20; 9.6 nmol/kg, n=15; 12.8 nmol/kg, n=20). Oocytes were retrieved 36 h after kisspeptin-54 administration, assessed for maturation, and fertilized by intra-cytoplasmic sperm injection (ICSI) with subsequent transfer of one or two embryos. Women were routinely screened for the development of OHSS.
Main outcome measure: Oocyte maturation was measured by oocyte yield (percentage of mature oocytes retrieved from follicles ≧14 mm on ultrasound). Secondary outcomes include rates of OHSS and pregnancy.
Results: Oocyte maturation occurred in 95% of women. Highest oocyte yield (121%) was observed following 12.8 nmol/kg kisspeptin-54, which was +69% greater than following 3.2 nmol/kg. At all doses of kisspeptin-54, biochemical pregnancy, clinical pregnancy and live birth rates per transfer (n=51) were 63, 53 and 45%, respectively. Highest pregnancy rates were observed following 9.6 nmol/kg kisspeptin-54 (85, 77 and 62%, respectively). No woman developed moderate, severe or critical OHSS.
Conclusion: Kisspeptin-54 is a promising approach to effectively and safely trigger oocyte maturation in women undergoing IVF treatment at high risk of developing OHSS.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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