Follicular growth and trigger timing project
Research type
Research Study
Full title
Establishing the optimal timing of HCG oocyte maturation trigger during ovarian stimulation phase of IVF cycles using machine learning techniques
IRAS ID
275218
Contact name
Isla Robertson
Contact email
Sponsor organisation
University of Southampton
Duration of Study in the UK
0 years, 5 months, 23 days
Research summary
This project aims to use a database of IVF cycles to create an algorithm based decision aid to help clinicians decide when to administer the maturation trigger during the ovarian stimulation phase of an IVF cycle. This aims to reduce decision making variability and optimise timing, to maximise the number of mature eggs obtained, hopefully to improve the likelihood of live birth +/- the freezing of embryos for a subsequent treatment cycle.
In an IVF cycle, stimulation injections are given to override the normal negative feedback loop that causes only one dominant follicle to develop each month. This encourages superovulation, so that many follicles develop on both ovaries within the same cycle. Transvaginal follicle tracking scans are performed regularly and the diameters of each follicle are plotted on an electronic database to create a follicle graph. Each day, the charts are reviewed and when the follicles are judged to be sufficiently large, a trigger injection is given to promote oocyte maturation. 36 hours after the trigger injection, the eggs are retrieved from the follicles in a transvaginal egg collection procedure, performed under sedation. Embryos are then created in the embryology laboratory using IVF or ICSI techniques and the best available embryo transferred to the patient’s uterus. Any additional good quality embryos are frozen for use in future frozen transfer cycles, removing the need for the woman to undergo the ovarian stimulation phase of another fresh IVF cycle.
Optimal trigger timing is currently not evidence-based. The latest ESHRE group recommendations on ovarian stimulation stated ‘The association of follicle size as a triggering criterion with outcome has not been sufficiently studied. Physicians may choose the follicle size upon which final oocyte maturation is triggered on a case to case basis’. This study aims to provide an evidence-based tool to assist in these decisions.REC name
HSC REC B
REC reference
20/NI/0037
Date of REC Opinion
25 Feb 2020
REC opinion
Favourable Opinion