Abstract
To explore whether dual triggering for final oocyte maturation using a low dose of recombinant human chorionic gonadotropin (hCG) plus gonadotropin-releasing hormone agonist (GnRH-a) is as effective as the standard dose of recombinant hCG triggering alone in term of a total number of retrieved oocytes, fertilization and pregnancy rate in fresh autologous antagonist intracytoplasmic sperm injection (ICSI) cycles. 80 infertile women undergoing ICSI, aged ˂ 40 years, 18˂ Body mass index ˂30 Kg/m2 included in fresh autologous antagonist ICSI cycles. 40 women received a Standard dose of recombinant hCG (500 µg) alone and 40 women received GnRH-a (0.2 mg triptorelin plus 250 µg recombinant hCG) were used for final oocytes maturation. This study was conducted at the High Institute for Infertility Diagnosis and Assisted Reproductive Techniques, Al Nahrain University. The mean total number of retrieved oocytes, fertilization, and pregnancy rate were measured. The mean total oocyte number being statistically higher in the dual trigger group. The mean number of fertilized oocytes and clinical pregnancy rates was higher in the dual trigger group than in the control group, but the difference showed borderline statistical significance. Furthermore, fertilization rates show no statistical difference between the control group and the dual trigger group. Results of the study confirm that dual triggers show favorable improvement in fresh autologous antagonist ICSI cycles with the use of GnRH agonists plus hCG compared with hCG alone for triggering of final oocyte maturation.
Highlights
The most essential part of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) is to control ovarian stimulation with exogenous gonadotropin to retrieve a rational number of mature oocytes for IVF and ICSI (Allegra, et al, [1])
Induce final oocyte maturation with hormonal stimulus has a major influence on retrieval oocyte, implantation rate, and safety which is characterized by the risk of ovarian hyperstimulation syndrome (OHSS) that is the most dangerous complication associated with control ovarian stimulation in assisted reproductive techniques (ART)
There was a highly significant difference in mean serum human chorionic gonadotropin (hCG) hormone on day oocyte pick up between control and dual trigger group with the level being higher in the hCG control group (P
Summary
The most essential part of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) is to control ovarian stimulation with exogenous gonadotropin to retrieve a rational number of mature oocytes for IVF and ICSI (Allegra, et al, [1]). Induces LH receptor formation on luteinized granulosa cells and promotes oocytes maturation through stimulating the resumption of oocyte meiosis and cumulus expansion (Griffin, et al, [3]). Preparation of the mature follicles for the preovulatory LH surge results in granulosa cell luteinization (Lawrenz, et al, [4]). It results in shortness of LH surge duration, and a negative effect on endometrial receptivity with subsequent abnormal corpora lutea formation, this Shortness duration of the induced LH/FSH peak leads to deficient luteal phase with premature luteolysis and implantation failure (El Tokhy, et al, [5]).
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