Double HCG trigger improves recovery of oocytes in women with a paucifollicular response to ovarian stimulation: A pilot study.

Abstract

To examine whether adding a second HCG trigger, 12.5h after the first (36.5h before ovarian puncture), can facilitate recovery of oocytes in women with a paucifollicular response to ovarian stimulation. A total of 85 women aged 35-42years, with a paucifollicular response to ovarian stimulation and who had experienced a total failure of oocyte recovery after the standard HCG ovulation trigger 36.5h before ovarian puncture, were subsequently treated by the same protocol but with the addition of a second HCG trigger 12.5h later. The recovered oocytes were inseminated by intracytoplasmic sperm injection (ICSI) and all available embryos were transferred 3days later. The double trigger enabled recovery of cumulus oophorus cells from most of the follicles in the women who experienced failure of total recovery of oocytes after a single trigger. Fifteen patients became pregnant, and no signs of ovarian hyperstimulation syndrome were observed. Nine women delivered a healthy child. In women aged 35-42years with a paucifollicular response to ovarian stimulation, a double HCG trigger appears to improve the rate of oocyte recovery. The conclusion of this pilot study needs to be confirmed by larger prospective trials.