"Dual trigger with gonadotropin-releasing hormone agonist and human chorionic gonadotropin significantly improves oocyte yield in normal responders on GnRH-antagonist cycles"

      Soha Albeitawi, Ehab Abu Marar, Firas Al. Reshoud, Jehan Hamadneh, Rami Hamza, Ghassan Alhasan, Haya Omeish, Paola Vigano

    This paper is published in "JBRA Assisted Reproduction"

     2021;00(0):00-00

     Publication Date: August 2021

      Publisher: Brasília/DF : Brazilian Society of Assisted Reproduction

      Main researcher: Dr. Soha Albeitawi, Dept. of Clinical Medical Sciences CMS

     YU medical student participation: Haya Omeish

               doi: 10.5935/1518-0557.20210039

Abstract

 Objective: During in vitro fertilization (IVF) cycles, final oocyte maturation is usually triggered by human Chorionic Gonadotropin (hCG) for its known effect in mimicking Luteinizing Hormone (LH) surge; however, with the widespread use of the ‘antagonist protocol’, Gonadotropin Releasing Hormone agonist (GnRHa) is being more commonly employed as a trigger in order to minimize or eliminate the risk of ovarian hyper-stimulation syndrome (OHSS). Many studies proved its efficacy in inducing oocyte maturation and its safety in preventing OHSS in high-risk groups. Moreover, some studies showed that GnRHa trigger may improve oocyte yield. This study aimed to further explore any beneficial effect of adding GnRHa to hCG (dual trigger) on oocyte yield and fertilization rate in normal responder women. Methods: We retrospectively reviewed and analyzed the data from 127 patients on antagonist protocol (67 dual trigger and 60 HCG trigger).

Results: The number of total oocytes, the number of MII oocytes and the number of fertilized oocytes were all significantly higher with the dual trigger protocol compared to hCG-only trigger. However, there is no significant difference in clinical pregnancy rate.

Conclusions: Using the dual trigger improved the number and quality of oocytes, and the fertilization rate in normal responders