Archives of Gynecology and Obstetrics

, Volume 298, Issue 1, pp 17–26 | Cite as

Dual triggering with GnRH agonist plus hCG versus triggering with hCG alone for IVF/ICSI outcome in GnRH antagonist cycles: a systematic review and meta-analysis

  • Chi-Huang Chen
  • Chii-Ruey Tzeng
  • Peng-Hui Wang
  • Wei-Min Liu
  • Heng-Yu Chang
  • Huang-Hui Chen
  • Ching-Hui Chen



To summarize available evidence from randomized-controlled trials which have evaluated triggering of final oocyte maturation with concomitant GnRH agonists and hCG in patients undergoing IVF, and to analyze whether dual triggering is as efficacious as hCG triggering in terms of oocyte and pregnancy outcomes.


A comprehensive literature search was performed to identify randomized-controlled trials comparing IVF outcomes between women receiving combined administration of hCG with GnRH agonists and those receiving hCG alone for triggering of final oocyte maturation.


Four studies including 527 patients eligible for inclusion in meta-analysis were identified. No significant difference in the number of mature oocytes or fertilized oocytes retrieved was found between groups. Clinical pregnancy rate with dual triggering was significantly higher as compared with hCG-alone triggering (pooled OR = 0.48, 95% CI 0.31–0.77, P = 0.002), but there was no significant difference in the ongoing pregnancy rate between groups.


Results of meta-analysis indicate comparable or significantly improved outcomes with the use of GnRH agonists plus hCG as compared with hCG alone for triggering of final oocyte maturation.


GnRH agonist plus hCG hCG In vitro fertilization Ovarian hyperstimulation syndrome 




Authors’ contributions

C-HuangC: project development and data analysis. CRT, PHW, WML, HYC, and HHC: Data collection and data analysis. C-HuiC: project development, data collection, data analysis, and manuscript writing.



Compliance with ethical standards

Conflict of interest

The authors declare they have no known conflicts of interest in this work.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyTaipei Medical University HospitalTaipeiTaiwan
  2. 2.Department of Obstetrics and Gynecology, School of Medicine, College of MedicineTaipei Medical UniversityTaipeiTaiwan
  3. 3.Department of Obstetrics and GynecologyTaipei Veterans General HospitalTaipeiTaiwan
  4. 4.Department of Obstetrics and Gynecology, School of MedicineNational Yang-Ming UniversityTaipeiTaiwan
  5. 5.Department of Biochemistry and Molecular Cell Biology, School of Medicine, College of MedicineTaipei Medical UniversityTaipeiTaiwan
  6. 6.Graduate Institute of Medical Sciences, College of MedicineTaipei Medical UniversityTaipeiTaiwan
  7. 7.Department of Obstetrics and GynecologyTaipei Medical University Hospital and Taipei Medical UniversityTaipeiTaiwan

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