Dual trigger with combination of gonadotropin releasing hormone agonist and human chorionic gondadotropin significantly improves live birth rate for normal responders in GnRH antagonist cycles

Dual trigger with gonadotropin-releasing hormone (GnRH) agonist and human chorionic gonadotropin improves implantation, clinical pregnancy, and live-birth rates for normal responders in GnRH-antagonist IVF-ICSI cycles.

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Authors

Ming-Hui Lin, M.D., Frank Shao-Ying Wu, M.D., Robert Kuo-Kuang Lee, M.D., Sheng-Hsiang Li, Ph.D., Shyr-Yeu Lin, M.D., Yuh-Ming Hwu, M.D.

Volume 100, Issue 5, Pages 1296-1302, November 2013

Abstract

Objective:

To investigate whether dual triggering of final oocyte maturation with a combination of gonadotropin-releasing hormone (GnRH) agonist and human chorionic gonadotropin (hCG) can improve the live-birth rate for normal responders in GnRH-antagonist in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI) cycles.

Design:

Retrospective cohort study.

Setting:

Infertility unit of a university-affiliated medical center.

Patient(s):

Normal responders to controlled ovarian hyperstimulation who were undergoing IVF-ICSI with a GnRH antagonist protocol.

Intervention(s):

Standard dosage of hCG trigger (6,500 IU of recombinant hCG) versus dual trigger (0.2 mg of triptorelin and 6,500 IU of recombinant hCG).

Main Outcome Measure(s):

Live-birth, clinical pregnancy, and implantation rates per cycle.

Result(s):

A total of 376 patients with 378 completed cycles with embryo transfer were enrolled (hCG trigger/control group: n = 187; dual trigger/study group: n = 191). The dual trigger group demonstrated statistically significantly higher implantation (29.6% vs. 18.4%), clinical pregnancy (50.7% vs. 40.1%), and live-birth (41.3% vs. 30.4%) rates as compared with the hCG trigger group. There was no statistically significant difference in terms of patient demographics, cycle parameters, or embryo quality.

Conclusion(s):

Dual trigger of final oocyte maturation with a GnRH-agonist and a standard dosage of hCG in normal responders statistically significantly improves implantation, clinical pregnancy, and live-birth rates in GnRH-antagonist IVF cycles.

Read the full text at: http://www.fertstert.org/article/S0015-0282(13)02762-3/fulltext


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Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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