Ovulation induction and luteal support with GnRH agonist in patients at high risk for hyperstimulation syndrome.

The aim of this study was to compare GnRHa trigger and luteal addition of triptorelin to hCG trigger for final oocyte maturation in women at high risk for OHSS undergoing IVF. A total of 423 patients were divided in two groups both stimulated using antagonist short protocol. Gonadotropins 75-150 UI/day were started on day 2-5, GnRH antagonist was added when the lead follicle was >14 mm and the final trigger was obtained with hCG 250 µg or triptorelin 0.2 mg. The luteal phase was supported with progesterone alone in the hCG group, with progesterone plus triptorelin 0.1 every other day from embryo transfer in the triptorelin group. In the triptorelin group we did neither have to suspend any embryo transfer, nor we have any early clinical OHSS. In the control group, 13 patients were suspended due to symptomatic high risk for OHSS and two patients developed a clinically significant OHSS. No statistically significant difference was observed in terms of clinical and ongoing pregnancy rates and implantation rates. Our results indicate that a protocol including GnRHa as trigger and an intensive luteal phase supported with GnRHa is safer than a standard antagonist protocol using hCG as trigger. It displays similar results, therefore it can be used as the first choice in patients at high risk for OHSS.

Agronomic characterization and α- and ß-ODAP determination through the adoption of new analytical strategies (HPLC-ELSD and NMR) of ten sicilian accessions of grass pea.

Ten accessions of grass pea (Lathyrus sativus L.) from different Sicilian sites, cultivated in the same environmental conditions, were analyzed for their morphological and productive parameters and for the content of two non-protein amino acids: α- and ß-ODAP (α- and ß-N-oxalyl-l-α,ß-diaminopropionic acid). The ß-isomer is the neurotoxin responsible for the neuron disease known as lathyrism. This analysis was carried out using two common analytical methodologies never applied in their determination, an HPLC separation with evaporative light scattering (ELS) as detector, and nuclear magnetic resonance (NMR). The content of the two isomers falls in the range reported for these compounds: 0.42-0.74 and 2.69-4.59 g/kg for α- and ß-ODAP, respectively; and the two methods yield comparable results. High productivity and a high protein content were detected in three Sicilian accessions. Low ß-ODAP content was found to be linked to accessions with heavier seeds and those originating at lower altitudes.