Dual trigger of oocyte maturation with gonadotropin-releasing hormone agonist and low-dose human chorionic gonadotropin to optimize live birth rates in high responders

Capsule:
Dual trigger with GnRH agonist and low-dose hCG in high responders with peak E2 levels

Authors:
Daniel Griffin, M.D., Claudio Benadiva, M.D., Nicole Kummer, M.D., Tara Budinetz, D.O., John Nulsen, M.D., Lawrence Engmann, M.D.
Volume 97, Issue 6 , Pages 1316-1320, June 2012

Objective:
To compare live birth rates after dual trigger of oocyte maturation with GnRH agonist (GnRHa) and low-dose hCG versus GnRHa alone in high responders with peak E2

Design:
Retrospective cohort study.

Setting:
University-based tertiary-care fertility center.

Patient(s):
Patients

Intervention(s):
GnRHa alone versus dual trigger.

Main Outcome Measure(s):
Live birth, implantation, and clinical pregnancy rates and OHSS.

Result(s):
The dual-trigger group had a significantly higher live birth rate (52.9% vs. 30.9%), implantation rate (41.9% vs. 22.1%), and clinical pregnancy rate (58.8% vs. 36.8%) compared with the GnRHa trigger group. One case of mild OHSS occurred in the dual-trigger group, and there were no cases of OHSS in the GnRHa trigger group.

Conclusion(s):
Dual trigger of oocyte maturation with GnRHa and low-dose hCG in high responders with peak E2

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