P-584 Dual trigger with hCG plus GnRHa for final oocyte maturation in PGT-A cycles results in similar euploidy rates when compared to hCG only trigger

Abstract

Abstract Study question To assess whether dual trigger alters the ploidy chance of a blastocyst in preimplantation genetic screening for aneuploidy (PGT-A) cycles Summary answer Compared to hCG triggerring, dual triggerring does not provide an additional superiority on blastocyst euploidy rate. What is known already Variables that may affect euploidy rates in various stages of an IVF cycle such as total gonadotropin dosage, stimulation regimen, ovarian response and switching to natural cycle were not shown to affect blastocyst euploidy rates. Furthermore, there is no difference when final oocyte maturation is triggered with hCG or GnRHa. On the other hand, it has been shown that dual trigger with hCG plus GnRHa may result in a higher maturation rate in oocytes, compared to hCG only trigger. There are controversial data in the literature about the effect of dual trigger on euploidy rates. Study design, size, duration This is a retrospective cohort study of 385 PGT-A cycles performed over a 7-year time period between May 2012 and April 2019 at a single tertiary center for various indications. Participants/materials, setting, methods All couples undergoing IVF/intracytoplasmic sperm injection (ICSI) with planned PGT-A were included in the study, regardless of whether an embryo transfer was performed or not. Final oocyte maturation was triggerred using human chorionic gonadotropin (hCG) or the combination of hCG and gonadotropin releasing hormone agonists (GnRHa) (Dual trigger). Participants were divided based on triggering method and all demographic and clinical characteristics of the patients were compared. Main results and the role of chance Final oocyte maturation was triggered in 143 cycles with hCG (37.1 %), and in 242 cycles with dual trigger (62.9 %). The duration of stimulation was shorter in dual trigger arm compared to hCG trigger group (10.0 ± 1.6 vs. 9.4 ± 1.4 days, p = <.001). Euploidy rates per blastocyst tested were 23.4 %, and 26.1 % respectively for hCG and dual trigger groups with no significant difference. When the patients were stratified according to age, euploidy rate was higher in the dual trigger group in all age groups with no significance. There was no significant difference between hCG and dual trigger groups, regarding positive pregnancy result and ongoing pregnancy rates (p = .779 vs. p = .188). Limitations, reasons for caution Retrospective design and small sample size could be accepted as the limitations. Wider implications of the findings Our study is the first study in literature exploring the ploidy status of embryos following dual trigger with hCG + GnRHa for final oocyte maturation in PGT-A cycles and, comparing it with hCG only trigger. Dual triggerring of final oocyte maturation results in similar euploidy rates in blastocysts tested. Trial registration number 2020/004