The COH protocols included the antagonist protocol, long agonist protocol, mild stimulation protocol, progestin-primed ovarian stimulation (PPOS), and ultra-long agonist protocol [17 (link)]. Recombinant human chorionic gonadotropin (r-hCG) (Merck Serono, Germany), triptorelin (Ferring, Germany), or a combination of both r-hCG and triptorelin was used for triggering to promote oocyte maturation when the diameters of at least two dominant follicles reached 18 mm. Oocytes were retrieved 36 to 38 h thereafter. IVF or ICSI was performed 39 to 40 h after ovulation induction, and the pronuclear (PN) check for fertilization was performed 16 to 18 h later. The culture medium used in the study were G-IVF (Vitrolife Sweden AB, Sweden), G-1 (Vitrolife Sweden AB, Sweden), and G-2 (Vitrolife Sweden AB, Sweden). The incubator conditions were 6% CO2, 5% O2, and 89% N2. The oocytes were placed in G-IVF for fertilization and transferred to G-1 after 16 to 18 h later. Every embryo was cultured to day 3 and scored according to ASEBIR consensus [18 (link)] by two embryologists. Grade A and grade B embryos were good-quality embryos: grade A: 7–8 symmetrical blastomeres with fragmentation ≤ 10%, no multinucleation; grade B: 7–8 symmetrical blastomeres with fragmentation > 11% and ≤ 25%, or ≥ 9 cells with symmetry and ≤ 25% fragmentation. The rest were LGCEs.
Triptorelin
Manufactured by Ferring
Sourced in Germany, Switzerland
Triptorelin is a synthetic hormone used in laboratory settings. It functions as an agonist of the gonadotropin-releasing hormone (GnRH) receptor.
Automatically generated - may contain errors
Lab products found in correlation
Gonal f, by Merck Group (9 mentions)
Decapeptyl, by Ferring (2 mentions)
Menopur, by Ferring (2 mentions)
Ovidrel, by Merck Group (2 mentions)
Puregon, by MSD (1 mentions)
Menogon, by Ferring (1 mentions)
Orgalutran, by MSD (1 mentions)
Cetrotide, by Merck Group (1 mentions)
Unicel dxi 800, by Beckman Coulter (1 mentions)
G ivf, by Vitrolife (1 mentions)
Human irisin elisa kit, by Cusabio (1 mentions)
Cl 2000i, by Mindray (1 mentions)
Ts100, by Nikon (1 mentions)
Subcutaneous triptorelin, by Ferring (1 mentions)
Cetrorelix, by Merck Group (1 mentions)
Ovitrelle, by Merck Group (1 mentions)
Puregon, by Organon (1 mentions)
G series culture media, by Vitrolife (1 mentions)
21 protocols using triptorelin
1
Comprehensive IVF Oocyte Retrieval and Embryo Culture
2
Triptorelin Mitigates Cyclophosphamide-Induced Brain Damage
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Rats were randomly divided into four groups of 10. Group I: healthy normal control group that received 0.5 mL saline by injection for 4 weeks; Group II: CP control that received intraperitoneal CP (Baxter Oncology, USA, 65 mg/kg/day) for 4 weeks; Group III: triptorelin (Decapeptyl, 1 mg) control that received subcutaneous triptorelin (Ferring, Switzerland, 0.05 mg/kg/day) for 4 weeks; and Group IV: triptorelin-treated group that received intraperitoneal CP (65 mg/kg/day) and subcutaneous triptorelin (0.05 mg/kg/day) for 4 weeks. The rats were anesthetized by inhalation of pentobarbital overdose (200 mg/kg) followed by rapid cervical dislocation and decapitation. This was followed by harvesting of brain tissues, which were placed in 10% formaldehyde.
3
GnRH-a Long Protocol for Ovarian Stimulation
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In the GnRH-a long protocol, patients were treated with daily injection of 0.1 mg or 0.05 mg Triptorelin acetate (Triptorelin, Ferring GmbH, Kiel, Germany, specifications: 1 ml; 0.1 mg) beginning in the middle of the luteal phase of the previous menstrual cycle. The entire injection period lasted 14–16 days. The serum hormone levels (follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone, and B-ultrasound were checked on the 3rd to 5th day of the menstruation cycle, and then, gonadotropin (Gn) (Recombinant Human Follitropin Alfa for Injection, MerckSeronoS.p.A, Geneva, Switzerland, Specification: 5.5 μg or 75 IU) was used after the down-regulation standard was reached (FSH ≤5 mIU/ml, LH ≤5 mIU/ml, E2 ≤50 pg/ml, progesterone ≤1.5 ng/ml, and EMT ≤5 mm). The initial dose of Gn was 125–375 IU per day, depending on the patient’s age, body mass index (BMI), basal follicle number, basal serum FSH (bFSH), and anti-Mullerian hormone (AMH) level. The dose of Gn was adjusted according to the growth of the follicle and the hormone results.
4
GnRH Antagonist Stimulation Protocol
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Hormonal stimulation was performed in GnRH antagonist protocols with recombinant FSH (Puregon®, MSD; Gonal F®, MerckSerono) or human menopausal gonadotropin (Menogon® or Menopur®, Ferring). The starting dosage was chosen according to the results of the anti-Müllerian hormone and antral follicle count (14 (link)). Starting on day 5, patients received a daily dosage of 0.25 mg GnRH antagonist (Orgalutran®, MSD or Cetrotide®, MERCK) to prevent premature ovulation.
During the stimulation course, stimulation dosage was adapted to the individual patient’s response. GnRH agonist trigger for final oocyte maturation was used to avoid OHSS as the ultrasound showed >13 follicles with a size of ≥11 mm (13 (link)). Patients received 0.3 mg of Triptorelin (Decapeptyl®, Ferring) for final oocyte maturation, as soon as ≥3 follicles were ≥17 mm in diameter. OPU was performed 36 h later under mild sedation, aspirating all follicles of a size of ≥11 mm.
During the stimulation course, stimulation dosage was adapted to the individual patient’s response. GnRH agonist trigger for final oocyte maturation was used to avoid OHSS as the ultrasound showed >13 follicles with a size of ≥11 mm (13 (link)). Patients received 0.3 mg of Triptorelin (Decapeptyl®, Ferring) for final oocyte maturation, as soon as ≥3 follicles were ≥17 mm in diameter. OPU was performed 36 h later under mild sedation, aspirating all follicles of a size of ≥11 mm.
5
Long Mid-Luteal GnRH Agonist Superovulation Protocol
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In all the cases, a long mid-luteal GnRH agonist protocol was adopted for superovulation. Down-regulation was carried out using daily GnRH agonist (triptorelin, s.c.0.1 mg, Ferring, Pharmaceuticals, Kiel, Germany) beginning on day 21 of the previous cycle, as confirmed by a blood test. After 2–3 weeks of down-regulation, confirmed by a blood test and ultrasound, gonadotropin (Gonal-F, im, 75 IU or 450 IU, Merck-Serono, Aubonne, Switzerland) was administered intramuscularly at 112.5–225 IU/day starting on cycle days 5–8 of stimulation. Gn dose was adjusted according to ovarian response. All patients were monitored using transvaginal ultrasound and serum ovarian steroid hormone concentrations during superovulation. Final oocyte maturation was triggered when at least three follicles ≥ 17 mm were present on ultrasound, with administration of 6000–8000 IU hCG injection (hCG, 1000 IU, Lizhu Pharmaceuticals, Zhuhai, China). Transvaginal oocyte aspiration was performed 36 h later by ultrasound-guided follicle puncture. All embryos were cryopreserved on day 3 after IVF due to high risk of OHSS and/or severe early-developing OHSS.
6
IVF Stimulation and Oocyte Retrieval
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All patients received a midluteal phase downregulation regimen (long protocol). Pituitary function was suppressed with the gonadotropin-releasing hormone agonist Triptorelin (Ferring GmbH, Kiel, Germany) until withdrawal menstrual bleeding and suppressed estradiol (E2) concentrations were achieved. Concomitant stimulation was performed with recombinant FSH (Gonal F, Merck Serono, Geneva, Switzerland). Each ovarian stimulation cycle was monitored by serial vaginal ultrasound examinations and measurement of serum E2 levels, and the dosage of gonadotropin was adjusted accordingly. Ovulation was induced with an injection of 250 μg human chorionic gonadotropin (hCG; Ovidrel, Merck Serono, Geneva, Switzerland) when at least two follicles had a diameter of at least 18 mm. Oocytes were retrieved at 36 h after hCG injection under vaginal ultrasound guidance. The culture and insemination of oocytes were performed in IVF medium (G-IVF PLUS; Vitrolife Sweden AB, Göteborg, Sweden) in an atmosphere of 6% CO2 in air at 37°C, at 39–40 h after the injection of hCG.
7
Endometrial Preparation Protocols for FET
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Endometrial preparation protocols were described in our previous report.10 (link) Briefly, the GnRH-a pretreatment group received a depot of long-acting GnRH agonist (1.0 mg Triptorelin, Ferring GmbH, Kiel, Germany). Both the GnRH-a pretreatment and no pretreatment groups received sequentially increasing doses of oral estradiol valerate (Progynova, Schering AG, Berlin, Germany). Progesterone treatment was started when the endometrial thickness reached a minimum of 8 mm and the blood estradiol level surpassed 100 pg/mL; the criteria were met after 10 to 20 days of oral estrogen supplementation in all patients who were included in the analysis. Intramuscular injections of progesterone in oil (20 mg per ampoule; Shanghai General Pharmaceutical Factory, Shanghai, China) was started at 40 mg daily for 2 days and increased to 60 mg daily for the following 15 days. In cases of a successful pregnancy, progesterone was continued until 10 weeks of gestation. If endometrial thickness remained <8 mm after 20 days of oral estrogen supplementation, the embryo transfer was cancelled. Blastocysts were thawed on day 6 of progesterone initiation and embryo transfer was performed on the day of thawing.
8
Diagnosis of Central Precocious Puberty
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The GnRH stimulation test was performed using subcutaneous administration of the GnRH analogue triptorelin (Ferring AG, Saint-Prex, Switzerland). The dosage was 2.5 µg/kg with a maximum dose of 100 µg. Then, blood samples were drawn at the 0′, 30′, 60′, and 90′ time points to examine LH and follicle-stimulating hormone (FSH) concentrations. Serum LH and FSH were measured by immunochemiluminescent assay (ICMA) using a Beckman UniCel DxI800 automatic chemiluminescence analyser. The GnRH stimulation test was performed in patients with breast development and LH > 0.1–0.2 IU/L. CPP was diagnosed when the peak value of LH was greater than 5.0 U/L, and the LH/FSH ratio was greater than 0.6.
9
GnRH Stimulation Test for Precocious Puberty
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In all individuals, height, weight and Tanner staging for breast development were measured by an experienced pediatric endocrinologist. BA and uterine and ovarian ultrasounds were performed in girls with CPP and PT. BMI was calculated as weight (kg) /height (m)2.
The GnRH stimulation test was carried out by subcutaneously injecting 2.5 μg/kg (up to 100 μg) of triptorelin (Ferring GmbH), and blood samples were collected repeatedly at baseline and 30, 60, 90 and 120 min after the injection for gonadotropin measured. Girls with PLH values ≥ 5 IU/L were considered as activation of the hypothalamic–pituitary–ovarian axis. Serum LH, estradiol (E2), follicle-stimulating hormone (FSH) and insulin were tested using a chemiluminescence immunometric assay (Mindray, CL-2000i, Shenzhen, China). Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated as insulin (μIU/ml) × fasting blood glucose (mmol/L)/22.5. Irisin levels were measured by ELISA (Human Irisin Elisa Kit, CUSABIO, Wuhan, China), and the minimum detectable irisin level was 0.78 ng/mL. The corresponding intra- and inter-assay coefficients of variation were <8 and <10%.
The GnRH stimulation test was carried out by subcutaneously injecting 2.5 μg/kg (up to 100 μg) of triptorelin (Ferring GmbH), and blood samples were collected repeatedly at baseline and 30, 60, 90 and 120 min after the injection for gonadotropin measured. Girls with PLH values ≥ 5 IU/L were considered as activation of the hypothalamic–pituitary–ovarian axis. Serum LH, estradiol (E2), follicle-stimulating hormone (FSH) and insulin were tested using a chemiluminescence immunometric assay (Mindray, CL-2000i, Shenzhen, China). Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated as insulin (μIU/ml) × fasting blood glucose (mmol/L)/22.5. Irisin levels were measured by ELISA (Human Irisin Elisa Kit, CUSABIO, Wuhan, China), and the minimum detectable irisin level was 0.78 ng/mL. The corresponding intra- and inter-assay coefficients of variation were <8 and <10%.
10
Controlled Ovarian Hyperstimulation for IVF
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Recombinant FSH (Gonal-F, Serono Switzerland) was used for controlled ovarian hyperstimulation after pituitary down-regulation using GnRH agonist (triptorelin; Ferring Pharmaceuticals, Germany) initiated on Day 21 of the cycle as described previously.[11 (link)] Doses of rFSH (150–250 IU/d) were adjusted by estradiol levels and follicular growth. Once 3 or more follicles reached a diameter of >16 mm and the diameter of leading follicle reached ≥18 mm, final oocyte maturation was induced by 5000 to 10,000 IU of human chorionic gonadotropin (hCG, Ferring Pharmaceuticals). Oocyte retrieval was performed 36 hours after hCG was injected through the transvaginal route with an ultrasound guidance under local anesthesia.
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