Dual trigger with gonadotropin-releasing hormone and human chorionic gonadotropin for poor responders

Ahmet Eser,Evrim Bostancı Ergen,Belgin Devranoğlu,Çiğdem Yayla Abide

doi:10.4274/jtgga.2017.0045

Ahmet Eser, Evrim Bostancı Ergen + Show 2 more

Open Access

https://doi.org/10.4274/jtgga.2017.0045

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Abstract

Objective:To compare metaphase II (MII) rate, fertilization rate, and embryo quality with dual trigger gonadotropin-releasing hormone agonist (GnRH) and normal dose human chorionic gonadotropin (hCG) versus a normal dose hCG trigger in antagonist intracytoplasmic sperm injection (ICSI) cycles of poor ovarian responders.Material and Methods:Patients defined as poor ovarian responders according to the Bologna criteria who underwent ICSI with GnRH antagonist protocol and triggered with dual trigger or hCG alone for oocyte maturation. Main outcome measures were MII rate, fertilization rate, and embryo quality.Results:Total gonadotropin doses and E2 levels on trigger day were higher in the hCG trigger group. There were no significant differences with regard to implantation rate (p=0.304), biochemical pregnancy rate (p=0.815), clinical pregnancy rate (p=0.378), and ongoing pregnancy rate (p=0.635) between the groups.Conclusion:Dual trigger of oocyte maturation with GnRH agonist and normal dose hCG in poor responders does not demonstrate improved oocyte maturation, clinical pregnancy, and ongoing pregnancy rates.

Highlights

N versus a normal dose Human chorionic gonadotropin (hCG) trigger in antagonist intracytoplasmic sperm injection (ICSI) cycles of poor ovarian responders
A significantly differ between the dual trigger group and the hCG trigger group
Dual trigger group compared with hCG trigger group with regards to implantation rate, biochemical pregnancy rate, clinical pregnancy rate, and ongoing pregnancy rate

Summary

Introduction

N (hCG) versus a normal dose hCG trigger in antagonist intracytoplasmic sperm injection (ICSI) cycles of poor ovarian responders. Discussion This case-control study assessed the effect of dual triggering through an antagonist stimulation protocol in poor responder women undergoing ICSI cycles. Despite there being a scarcity of studies that investigated the impact of a dual trigger in the literature; a dual trigger with standard dose hCG provided higher oocyte retrieval numbers [7,12], higher numbers of retrieved M2 oocytes [7,12], higher M2 oocyte rates [7,12], higher numbers of cryopreserved embryos [7,23]; and improved implantation [7], clinical pregnancy [7,14] and live birth rates [7] in normal responder patients.

Results

Conclusion