Dual trigger improves response to ovarian stimulation and ICSI outcomes in patients with a previous r-hCG triggered ICSI cycle

• Published in: JBRA assisted reproduction Vol. 26; no. 2; pp. 255 - 260
• Main Authors: Setti, Amanda Souza, Maldonado, Luis Guilherme Louzada, Braga, Daniela Paes de Almeida Ferreira, Iaconelli Júnior, Assumpto, Borges Júnior, Edson
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Reprodução Humana (Brazilian Society of Assisted Reproduction) 2022; Brazilian Society of Assisted Reproduction
• Subjects: Age; Agonists; Body mass index; Case-Control Studies; Chorionic Gonadotropin - therapeutic use; Demographics; Embryos; Female; Fertilization in Vitro; Gonadotropin-Releasing Hormone; Humans; Infertility; Miscarriage; Oocytes; Original; Ovaries; Ovulation Induction; Pregnancy; Pregnancy Rate; Recombinant Proteins; Sperm; Sperm Injections, Intracytoplasmic; Variables; New York; United States > US; Switzerland; ICSI; implantation; oocyte maturation; ovarian stimulation
• ISSN: 1518-0557; 1517-5693; 1518-0557
• DOI: 10.5935/1518-0557.20210065

To evaluate if ovarian response to controlled ovarian stimulation (COS) and intracytoplasmic sperm injection (ICSI) outcomes are improved by the use of dual trigger (gonadotropin-releasing hormone (GnRH) agonists plus recombinant human chorionic gonadotropin (r-hCG)) in patients with previous cycles triggered with r-hCG. This case-control study included 88 matched cycles performed in 88 patients, which had the first ICSI cycle triggered with r-hCG (n=44), and the following ICSI cycle with dual trigger (n=44). We compared the cycle outcomes between the groups. In a second case-control within-subject analyses, we compared the ICSI outcomes between patients which had the first ICSI cycle triggered with r-hCG only (n=18), and the following ICSI cycle with dual trigger (n=18) or r-hCG only (n=18). Upon investigating repeated cycles (r-hCG only vs. dual trigger), we found higher oocyte yield and mature oocyte rates, lower immature oocyte rates, higher fertilization rates, and higher blastocyst development rates; and higher rates of cycles with embryos transferred and implantation in the dual trigger cycle. The dual trigger regimen is a more effective approach than r-hCG trigger in patients with a previous r-hCG triggered ICSI cycle, yielding improved response to COS, and better laboratorial and clinical outcomes.