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BioMed Research International
Volume 2014 (2014), Article ID 580171, 7 pages
http://dx.doi.org/10.1155/2014/580171
Review Article

Pharmaceutical Options for Triggering of Final Oocyte Maturation in ART

1Instituto Bernabeu, Avenida Albufereta 31, 03016 Alicante, Spain
2The Fertility Clinic, Skive Regional Hospital, Faculty of Health, Aarhus University, 7800 Skive, Denmark
3Faculty of Health, University of Southern Denmark, 5230 Odense M, Denmark

Received 3 April 2014; Revised 5 June 2014; Accepted 28 June 2014; Published 15 July 2014

Academic Editor: Raúl M. Luque

Copyright © 2014 Juan Carlos Castillo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Since the pioneering days of in vitro fertilization, hCG has been the gold standard to induce final follicular maturation. We herein reviewed different pharmaceutical options for triggering of final oocyte maturation in ART. The new upcoming agent seems to be GnRHa with its potential advantages over hCG trigger. GnRHa triggering elicits a surge of gonadotropins resembling the natural midcycle surge of gonadotropins, without the prolonged action of hCG, resulting in the retrieval of more mature oocytes and a significant reduction in or elimination of OHSS as compared to hCG triggering. The induction of final follicular maturation using GnRHa represents a paradigm shift in the ovulation triggering concept in ART and, thus, a way to develop a safer IVF procedure. Kisspeptins are key central regulators of the neuroendocrine mechanisms of human reproduction, who have been shown to effectively elicit an LH surge and to induce final oocyte maturation in IVF cycles. This new trigger concept may, therefore, offer a completely new, “natural” pharmacological option for ovulation induction. Whether kisspeptins will be the future agent to trigger ovulation remains to be further explored.