Seventy-six women requiring IVF treatment for infertility at Hammersmith Hospital, London, UK, were screened for participation between August 2015 and May 2016. The inclusion criteria aimed to select women at high risk of OHSS: serum anti-Müllerian hormone (AMH) ≥40 pmol/L (≥5.6 ng/mL) or total antral follicle count (AFC) ≥23 (Lee et al., 2008 ; Jayaprakasan et al., 2012 (link)); age 18–34 years; early follicular phase serum follicle stimulating hormone (FSH) ≤12 iU/L; both ovaries intact; body mass index 18–29 kg/m2. Exclusion criteria were moderate/severe endometriosis and poor response to or ≥2 previous cycles of IVF treatment.
Ten patients were not eligible for inclusion and two patients withdrew consent prior to commencing the study protocol (Fig. 1). A further two patients developed conditions requiring further management during the stimulation phase beyond the realms of the study protocol (e.g. hydrosalpinx) and were thus excluded prior to randomization. All treatment costs for the study cycle were covered by study participation. Sixty-two eligible patients underwent a single IVF treatment cycle and were randomized to receive either one (single; n = 31) or two doses (double; n = 31) of kisspeptin-54 to trigger oocyte maturation.
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