#287 : A Comparison of hCG Trigger Versus Dual Trigger for Final Oocyte Maturation in Poor Ovarian Responders Undergoing Minimal Stimulation

Abstract

Background and Aims: Traditionally, hCG has been used for oocyte triggering. However, women with poor ovarian response manifest low oocyte yield and compromised occyte quality. More recently, a combination of hCG and GnRHa (dual trigger) has been shown to improve follcile collection yield and oocyte maturation. The aim of the study is tocompare the result of final oocyte maturation and the embryo formation between two groups of poor ovarian responders undergoing minimal stimulation after triggering by hCG alone versus dual trigger. Method: This randomized control trial was conducted at National Assisted Reproductive Center, National Hospital of Obstetrics and Gynecology. Patients defined as poor ovarian responders according to the Bologna criteria were equally divided into two groups: control (hCG trigger) and investigation (dual trigger) groups. The group received the hCG trigger (6500 IU) and the investigation group received the dual trigger (0.2 mg of Triptorelin plus 6500 IU of hCG). Minimal stimulation IVF protocols consist of 5 days of 100mg clomiphene citrate and small amounts of gonadotropin. Results: One hundred and two patients were included in the study, with 51 women in each treatment group. Dual triggering showed a significant higher number of retrieved oocytes (5.35 ± 3.13 vs 4.35 ± 2.44, P=0.038) and metaphase II oocytes (4.25 ± 3.12 vs 3.35 ± 2.02, P=0.043). Although not reaching statistical significances, increases in the number of fertilized oocytes, embryos, and number of top-quality embryos (TQE) were observed. Conclusion: Dual trigger for final oocyte maturation is associated with better IVF outcome in poor ovarian responders undergoing minimal stimulation. Acknowledgements: The authors are grateful to all physicians, administrative staff at the National Assisted Reproductive Technology Center, National Hospital of Obstetrics and Gynecology, Vietnam for allowing and supporting us to undertake this research.