Final oocyte maturation with a dual trigger compared to human chorionic gonadotropin trigger in antagonist co-treated cycles: A randomized clinical trial

Abstract

Objective: This clinical trial compared the effect of a dual trigger treatment (combination of gonadotropin-releasing hormone (GnRH) agonist and human chorionic gonadotropin (hCG) and hCG alone on oocyte quality and metaphase II oocytes’ number. Methods: It was done on infertile couples who were undergoing intracytoplasmic sperm injection with GnRH-antagonist cycles in two infertility centers of Tehran. The main outcome measures were metaphase II oocytes’ number, clinical pregnancy, abortion, and implantation rates per cycle. Results: A total of 126 normal responder women who were considered for in vitro fertilization were equally divided into two groups: control (hCG trigger) and investigation (dual trigger) groups. The control group received the hCG trigger (10,000 IU) and the investigation group received the dual trigger (0.2 mg of Triptoreline plus 5000 IU of hCG). The metaphase II oocytes’ numbers, rates of clinical pregnancy, abortion and implantation were not significantly different between the two groups (P = 0.42, 0.70, 0.77, 0.80, respectively). Good quality embryos was significantly higher in the dual trigger group (P = 0.04). Conclusion: Final oocyte maturation with dual trigger improves the number of good quality embryos in normal responder women. Further research with larger sample size is needed to characterize the effect on oocyte quality and pregnancy rate. Keywords: Dual trigger, Gonadotropin releasing hormone agonist, Gonadotropin releasing hormone antagonist, Normal responders