Dual Trigger for Final Oocyte Maturation in ICSI Cycles: Does it Make a Difference?

Document Type : Original Article

Authors

1 Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University

2 Department of Obstetrics &Gynecology, Faculty of Medicine, Menoufia University

Abstract

Aim: To compare the outcomes of ICSI-fresh embryo transfer cycles by experimenting with various methods of final oocyte maturation triggering.
Methods: A randomized controlled trial consisted of a total of 348 patients who underwent controlled ovarian stimulation using gonadotropin-releasing hormone (GnRH) antagonist, With 174 participants split evenly across the two groups, 174 were triggered by hCG alone (10,000 IU hCG intramuscularly) and 174 were triggered by dual trigger (0.2 mg of triptorelin subcutaneously and 5,000 IU of hCG intramuscularly). Measures of outcome included the clinical pregnancy rate, ongoing pregnancy rate, and mature oocyte yield.
Results: The patient demographics and clinical characteristics of the dual and hCG trigger groups were similar. In terms of total number of oocyte obtained (p=0.312), oocyte quality (p=0.307), and number of embryos of good quality (p=0.567), there were no significant differences between the two groups. Dual trigger group yielded a significantly higher number/proportion of mature oocytes (p0.001) than the hCG only group. The rates of clinical pregnancy were higher with dual trigger compared to hCG alone (59.2% versus. 47.1%, p=0.032), while the rates of continuing pregnancy were not significantly different (p=0.054).
Conclusions: More mature oocytes were collected from the dual triggered group. Additionally, compared to the hCG trigger group, the dual trigger group achieved better results in clinical pregnancies following fresh embryo transfers.

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