Dual triggering for final oocyte maturation compared to single triggering in GnRH antagonist (IVF-ICSI) protocols (Randomized Controlled Trial) | ||
| The Egyptian Journal of Fertility and Sterility | ||
| Article 7, Volume 26, Issue 2, May 2022, Pages 49-60 PDF (3.08 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/egyfs.2022.237730 | ||
| Author | ||
| Marwan O. Elkady | ||
| Department of Obstetrics and Gynecology Faculty of Medicine, Ain Shams University | ||
| Abstract | ||
| Abstract Background: Infertility is one of the major medical problems in the world which has led to continuous research and advances in the field of assisted reproductive technology (ART), Aim of the work: to investigate whether co-administration of GnRH-a and hCG for final oocyte maturation (dual trigger) would improve number of oocytes retrieved& its quality and eventually IVF/ICSI clinical outcomes compared to single triggers in women with normal ovarian response undergoing (IVF/ICSI) technique using GnRH antagonist protocol of stimulation. Patients and Methods: A total 120 patients were included in this study, randomized and divided into two groups: Group (1): The study group; included 60 patients who received the dual trigger. Group (2): The control group; who included 60 patients, age matched, who received the hCG trigger alone. All participants were subjected to proper history taking, complete general, abdominal and pelvic examination, and full investigations to confirm criteria of the study. All participants were subjected to controlled ovarian hyper stimulation protocol according to GnRH antagonist protocol starting on day 2-3 of the menstrual cycle with a starting daily administration of FSH, human menopausal gonadotropin hMG, or highly purified hMG, or highly purified FSH or with recombinant FSH (r.FSH) intramuscularly for 4–5 days, and continued until the day of final oocyte maturation injection. Results: the current study showed statistically significant difference with p-value <0.05 between study groups as regards to the number of retrieved oocytes (cases: 11.42±4.2 vs. control: 9.8±4.9), number of MII oocyte retrieved (dual trigger: 6.2±2.7 vs. single trigger: 4.6±3.1), and number of fertilized oocyte (dual trigger: 4.03±2.2 vs. single trigger: 3.05±2.5) with higher mean among dual trigger group. In the current study also the dual-trigger group demonstrated a significantly higher percentage as regards to biochemical pregnancy rate (cases: 68.3%vs. 33.3% among controls), clinical pregnancy rate (cas- es: 58.3% vs. 31.7% among controls) and implantation rate (cases: 41.3% vs. 21.4% among controls) with a statistically significant difference with p-value <0.05 between study groups. Both groups showed no statistically significant difference as regards to the mean number of embryos transferred (1.9±1.01 in cases vs. 1.7±1.2 in control) and number of frozen embryos (1.33±1.08 in cases vs. 1.1±1.4 in control), or as regards to complications; whether ET cancellation or incidence of sever OHSS. Conclusion: In conclusion, in terms of the number of mature retrieved oocytes, implantation rate and clinical pregnancy rate in normal responders undergoing IVF/ICSI using antagonist protocols, a dual-trigger approach with a GnRH agonist and the standard dosage of hCG was found to be significantly superior to an hCG trigger alone. | ||
| Keywords | ||
| Key words: Dual triggering; oocyte maturation; single triggering; GnRH antagonist | ||
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