Dual-trigger Improves the Outcomes of in Vitro Fertilization Cycles in Older Patients with Diminished Ovarian Reserve: A Retrospective Cohort Study

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2020 Jul 7

PMID 32628729

Citations 17

Authors

Chyi-Uei Chern

Ju-Yueh Li

Kuan-Hao Tsui

Peng-Hui Wang

Zhi-Hong Wen

Li-Te Lin

Affiliations

Soon will be listed here.

Abstract

Background: Dual-trigger for final oocyte maturation has been applied on the women with poor ovarian response or diminished ovarian reserve. However, the results were controversial. The Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number (POSEIDON) stratification is a set of newly established criteria for low prognosis patients. The aim of this study was to examine the effectiveness of dual-trigger for final oocyte maturation on the in vitro fertilization (IVF) outcomes of patients who fulfill the POSEIDON group 4 criteria.

Methods: This retrospective cohort study investigated 384 cycles fulfilling the POSEIDON group 4 criteria. The patients underwent IVF treatment using the gonadotropin-releasing hormone (GnRH) antagonist protocol. The study group contained 194 cycles that received dual-trigger (human chorionic gonadotropin [hCG] plus GnRH-agonist) for final oocyte maturation. The control group included 114 cycles where final oocyte maturation was performed with only hCG. Baseline characteristics and cycle parameters, as well as IVF outcomes of both groups were compared.

Results: Baseline characteristics were similar between the dual trigger group and the control group. In terms of IVF outcomes, the dual trigger group demonstrated significantly higher number of retrieved oocytes, metaphase II oocytes, fertilized oocytes, day-3 embryos, and top-quality day-3 embryos. A statistically significant improvement in clinical pregnancy rate and live birth rate was also observed in the dual trigger group.

Conclusions: Our data suggests that dual trigger for final oocyte maturation might improve clinical pregnancy rates and live birth rates of IVF cycles in patients fulfilling the POSEIDON group 4 criteria.

Citing Articles

GnRH agonist-only trigger, compared to dual trigger, reduces oocyte retrieval rate in high responders without affecting cumulative live birth rate.

Wang Y, Yi Y, Guu H, Chen Y, Kung H, Chang J Front Endocrinol (Lausanne). 2024; 15:1461317.

PMID: 39229374 PMC: 11368714. DOI: 10.3389/fendo.2024.1461317.

Co-administration of GnRH-agonist and hCG (double trigger) for final oocyte maturation increases the number of top-quality embryos in patients undergoing IVF/ICSI cycles.

Tu B, Zhang H, Chen L, Yang R, Liu P, Li R J Ovarian Res. 2024; 17(1):137.

PMID: 38961417 PMC: 11223314. DOI: 10.1186/s13048-024-01465-6.

Reproductive outcomes of dual trigger therapy with GnRH agonist and hCG versus hCG trigger in women with diminished ovarian reserve: a retrospective study.

Chen K, Zhang C, Chen L, Zhao Y, Li H Reprod Biol Endocrinol. 2024; 22(1):35.

PMID: 38566172 PMC: 10985881. DOI: 10.1186/s12958-024-01211-z.

Comparison of pregnancy outcomes in women with normal ovarian response to the gonadotropin-releasing hormone agonist protocol using different trigger methods: a single-center retrospective cohort study based on propensity score matching.

Guo D, Pang C, Wang K Arch Gynecol Obstet. 2024; 309(5):2153-2165.

PMID: 38494512 DOI: 10.1007/s00404-024-07404-6.

The Implications of Double Human Chorionic Gonadotropin (hCG) Trigger on a Pseudo-Empty Follicle Syndrome Patient Seeking Infertility Treatment Through Assisted Reproductive Technology (ART).

Jadhav R, More A, Dutta S, Anjankar N, Shrivastava J Cureus. 2024; 16(1):e52783.

PMID: 38389636 PMC: 10882635. DOI: 10.7759/cureus.52783.

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