Innovative Methods in Assessing Follicular Status: Insights from IVF and Fertility Preservation

A single-center retrospective analysis (n=3,834) found that stopping routine post-GnRH agonist trigger hormone testing did not increase empty follicle syndrome (EFS) and yielded comparable embryologic outcomes. The retrospective cohort directly assessed the impact of omitting routine post-trigger assays; the primary outcome showed no statistically significant rise in EFS when testing was removed.

Previously, centers used routine post-GnRH agonist trigger hormone measurements to detect failed triggers and reduce EFS risk. This study finds no signal of harm from discontinuing that practice and suggests reductions in patient burden and cost; these data support protocol review rather than an immediate, universal practice change.

Secondary endpoints favored the no-testing group: mean oocyte yield 12.6 vs. 12.0 (p=0.03), mature oocytes 7.3 vs. 6.4 (p<0.01), and embryos suitable for clinical use 4.0 vs. 3.6 (p<0.01); fertilization rates were similar. These are associations, not causal proof. Clinically, omitting routine assays means fewer blood draws and modest cost savings and may allow reallocation of laboratory effort toward specimen processing and embryo culture.

What’s new: routine post-trigger hormone testing for GnRH agonist cycles appears dispensable for EFS surveillance in this cohort. The finding applies to reproductive endocrinologists, IVF nursing teams, and embryology labs and should prompt local, evidence-based protocol review.

Practical next steps include defining selective testing algorithms, aligning nursing phlebotomy workflows, and retraining lab staff to absorb reduced assay volume while protecting quality control. Centers that consider de-emphasizing routine checks should pilot changes and monitor EFS and embryology outcomes during the transition.