Dual Trigger Compared with Human Chorionic Gonadotropin Alone and Effects on Clinical Outcome of Intracytoplasmic Sperm Injection

Abstract

Background: This study compared outcomes of the standard 6000 IU human chorionic gonadotropin (hCG) triggerwith a dual trigger comprised of 6000 IU hCG and 1 mg leuprolide acetate for final oocyte maturation in an intracytoplasmic sperm injection (ICSI) cycle. By convention, ICSI was performed in most cases at the clinic.Materials and Methods: In this retrospective study, a total of 50 women were included in each arm. Participantswere matched for age, indication and number of prior assisted reproduction technology (ART) cycles. Women at riskfor ovarian hyperstimulation syndrome (OHSS) were excluded. A flexible gonadotropin releasing hormone (GnRH)antagonist protocol was used and final oocyte maturation was triggered when two leading follicles were >17 mm.Distribution of variables was evaluated visually with histograms. Continuous variables were defined by mean (standarddeviation) or median (25th-75th percentile) depending on distribution characteristics. Categorical variables weredefined by numbers and percentages. Continuous variables were compared between the groups with the t test orMann-Whitney U test as appropriate. Categorical variables were compared by the chi-square test and its derivativesas appropriate. A two-sided P<0.05 indicated statistical significance.Results: Both groups had similar antral follicle counts, median parity (0) and number of previous failed cycles (0).The median number of oocytes (8 vs. 7), metaphase-two oocytes (6 vs. 5.5), blastocysts (1 vs. 1), clinical pregnancyrates (CPR) (28% vs. 22%), ongoing pregnancy rates (OPR) (22% vs. 20%) and pregnancy rate per transfer (53.3%vs 53.8%) were similar between the dual trigger and hCG only groups, respectively.Conclusion: Dual trigger for oocyte maturation stimulation failed to improve the ICSI outcome.

Keywords

• dual trigger
• gnrh agonist
• human chorionic gonadotropin
• infertility
• in vitro fertilisation outcome