Factors Associated with the Efficacy of Mature Oocyte Production after Dual-Trigger Controlled Ovarian Stimulation using A GnRH Antagonist Protocol.

Abstract

The number of mature oocytes retrieved plays a significant role in determining embryo development and pregnancy outcomes of in-vitro fertilization (IVF). However, studies investigating factors predictive of the efficacy of mature oocyte production (EMOP) after dual-trigger controlled ovarian stimulation (COS) are rare. This study aims to identify key predictors of EMOP during dual-trigger COS with a GnRH antagonist protocol for IVF. This retrospective cohort study included 359 first-time IVF patients undergoing dual-trigger COS with a GnRH antagonist protocol. EMOP was defined as the ratio of MII oocyte count to antral follicle count (AFC). Based on EMOP results, patients were divided into two groups: Group A (EMOP < 70%; n = 232) and Group B (EMOP ≥ 70%; n = 127). Multivariate logistic regression analysis revealed that day-2 follicle-stimulating hormone (FSH), stimulation duration, and total oocyte count were the most significant predictors of EMOP (p < 0.05; odds ratios: 1.637, 3.400, and 1.530, respectively). Receiver operating characteristic analysis demonstrated that total oocyte count < 9.5 (AUC, 0.782; sensitivity, 76.2%; specificity, 69.2%; p < 0.001), and stimulation duration < 9.5 days (AUC, 0.725; sensitivity, 63.5%; specificity, 66.7%; p < 0.001) significantly predicted EMOP < 70%. Stimulation duration combined with total oocyte count exhibited the highest power in predicting EMOP < 70% (AUC, 0.767; sensitivity, 92.3%; specificity, 42.4%). Stimulation duration combined with total oocyte count was identified as the most important factor associated with the efficacy of mature oocyte production during dual-trigger COS in IVF using a GnRH antagonist protocol.