{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T17:24:33Z","timestamp":1778606673543,"version":"3.51.4"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T00:00:00Z","timestamp":1635120000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018552","name":"Science and Technology Plan Project of Taizhou","doi-asserted-by":"publisher","award":["1801ky31"],"award-info":[{"award-number":["1801ky31"]}],"id":[{"id":"10.13039\/501100018552","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Evidence-Based Complementary and Alternative Medicine"],"published-print":{"date-parts":[[2021,10,25]]},"abstract":"<jats:p>Objective. Ovarian hyperstimulation syndrome (OHSS) is a side effect of the exogenous human chorionic gonadotropin (hCG) hormones used to trigger oocyte maturation. High ovarian responders represent a population with a higher risk of OHSS and are characterized by an exaggerated response to gonadotropin administration. In this study, we compared clinical pregnancy and incidence of OHSS in high ovarian responders receiving different doses of hCG supplementation in a GnRH-agonist trigger protocol. Methods. A total of 205 high ovarian responders who were to undergo in vitro fertilization (IVF)\/intracytoplasmic sperm injection (ICSI) cycles were recruited and randomly assigned to receive different doses of hCG supplementation in a GnRH-agonist trigger protocol: GnRH-a (n\u2009=\u200942), GnRH-a\u2009+\u20091000\u2009IU hCG (n\u2009=\u200949), GnRH-a\u2009+\u20092000\u2009IU hCG (n\u2009=\u200954), and GnRH-a\u2009+\u20093000\u2009IU hCG (n\u2009=\u200960) groups. Results. The GnRH-a\u2009+\u20091000\u2009IU hCG, GnRH-a\u2009+\u20092000\u2009IU hCG, and GnRH-a\u2009+\u20093000\u2009IU hCG groups had more oocytes retrieved, embryos, high-quality embryos, and a higher rate of high-quality embryos than the GnRH-a group (<jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>p<\/a:mi>\n                        <a:mo>&lt;<\/a:mo>\n                        <a:mn>0.05<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>). The GnRH-a\u2009+\u20091000\u2009IU hCG group demonstrated more oocytes retrieved, embryos, high-quality embryos, and a higher rate of high-quality embryos than the GnRH-a\u2009+\u20092000\u2009IU hCG and GnRH-a\u2009+\u20093000\u2009IU hCG groups (<jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>p<\/c:mi>\n                        <c:mo>&lt;<\/c:mo>\n                        <c:mn>0.05<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>). No moderate and severe OHSS cases occurred in the GnRH-a and GnRH-a\u2009+\u20091000\u2009IU hCG groups. The incidence rate of moderate and severe OHSS was remarkably lower in the GnRH-a group and GnRH-a\u2009+\u20091000\u2009IU hCG groups than in the GnRH-a\u2009+\u20092000\u2009IU hCG and GnRH-a\u2009+\u20093000\u2009IU hCG groups (<jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>p<\/e:mi>\n                        <e:mo>&lt;<\/e:mo>\n                        <e:mn>0.05<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula>). The GnRH-a\u2009+\u20091000\u2009IU hCG, GnRH-a\u2009+\u20092000\u2009IU hCG, and GnRH-a\u2009+\u20093000\u2009IU hCG groups had a higher clinical pregnancy rate than the GnRH-a group, showing no significant difference (<jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>p<\/g:mi>\n                        <g:mo>&gt;<\/g:mo>\n                        <g:mn>0.05<\/g:mn>\n                     <\/g:math>\n                  <\/jats:inline-formula>). The GnRH-a\u2009+\u20091000\u2009IU hCG, GnRH-a\u2009+\u20092000\u2009IU hCG, and GnRH-a\u2009+\u20093000\u2009IU hCG groups had a lower abortion rate than the GnRH-a group (<jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mi>p<\/i:mi>\n                        <i:mo>&lt;<\/i:mo>\n                        <i:mn>0.05<\/i:mn>\n                     <\/i:math>\n                  <\/jats:inline-formula>). Conclusion. Based on the data obtained from this prospective study, we recommend 1000\u2009IU hCG supplementation in a GnRH-agonist trigger protocol for high ovarian responders during IVF\/ICSI cycles considering a higher rate of high-quality embryos, a lower incidence rate of moderate and severe OHSS, and a lower abortion rate.<\/jats:p>","DOI":"10.1155\/2021\/2180933","type":"journal-article","created":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T23:35:06Z","timestamp":1635204906000},"page":"1-7","source":"Crossref","is-referenced-by-count":6,"title":["Clinical Pregnancy and Incidence of Ovarian Hyperstimulation Syndrome in High Ovarian Responders Receiving Different Doses of hCG Supplementation in a GnRH-Agonist Trigger Protocol"],"prefix":"10.1155","volume":"2021","author":[{"given":"Xiuzhen","family":"Shen","sequence":"first","affiliation":[{"name":"Reproductive Center, Taizhou Hospital of Zhejiang Province, Taizhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qinjie","family":"Yang","sequence":"additional","affiliation":[{"name":"Ultrasound Department, Taizhou Hospital of Zhejiang Province, Taizhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lanfang","family":"Li","sequence":"additional","affiliation":[{"name":"Reproductive Center, Taizhou Hospital of Zhejiang Province, Taizhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1538-5199","authenticated-orcid":true,"given":"Wenhao","family":"Lu","sequence":"additional","affiliation":[{"name":"Reproductive Center, Taizhou Hospital of Zhejiang Province, Taizhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21031135"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dex027"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/bs.vh.2018.01.018"},{"issue":"3","key":"4","first-page":"248","article-title":"Ovarian hyperstimulation syndrome: a narrative review of its pathophysiology, risk factors, prevention, classification, and management","volume":"43","author":"B. 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