Abstract
Objective
It is well known that a dual trigger treatment can improve clinical outcomes of in vitro fertilization (IVF) in high or normal ovarian responders. However, it is not clear whether dual triggering also benefits patients with diminished ovarian reserve (DOR). The aim of this study was to investigate whether a dual trigger treatment of gonadotropin-releasing hormone (GnRH) agonist combined with human chorionic gonadotropin (hCG) for final follicular maturation improves the cumulative live birth rate (CLBR) during the GnRH-antagonist cycle in patients with DOR.
Methods
This retrospective study included patients with DOR who received a GnRH-antagonist protocol during IVF and intracytoplasmic sperm injection (IVF-ICSI) cycles at Peking University People’s Hospital from January 1, 2017 through December 31, 2017. Oocyte maturation was triggered by GnRH combined with hCG (n=110) or hCG alone (n=71). Embryos were transferred on the third day after oocyte retrieval or during a subsequent freeze-thaw cycle. Patients were followed up for 3 years.
Results
The dual trigger treatment did not affect CLBR, which is an overall determinant of the success rate of assisted reproductive technology (ART). Women in the dual trigger group had significantly higher rates of fertilization than those in the hCG group (90.1% vs. 83.9%, P=0.040).
Conclusion
Dual trigger with GnRH agonist and hCG did not improve CLBR in patients with DOR, but did slightly improve fertilization rate, oocyte count, and embryo quality.
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Acknowledgements
The authors thank the nurses and laboratory staff of the Department of Assisted Reproduction, Peking University Peoples’ Hospital for their contribution to this study.
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This study was supported by grants from the Scientific Research Development Fund of Peking University People’s Hospital (No. RDY2020-27), Clinical Medicine Plus X - Young Scholars Project, Peking University, and the Fundamental Research Funds for the Central Universities (No. PKU2021LCXQ020).
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Ren, Ym., Wang, Yb., Fu, M. et al. Effect of Dual Trigger In Vitro Fertilization and Intracytoplasmic Sperm Injection During the Gonadotropin-releasing Hormone-Antagonist Cycle on Final Oocyte Maturation and Cumulative Live Birth Rate in Women with Diminished Ovarian Reserve. CURR MED SCI 42, 1066–1070 (2022). https://doi.org/10.1007/s11596-022-2608-2
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DOI: https://doi.org/10.1007/s11596-022-2608-2