Effects of double trigger human chorionic gonadotropin combined with gonadotropin-releasing hormone agonists compared with single trigger human chorionic gonadotropin in high ovarian responders
Objective To analyze and compare the effects of using double trigger,gonadotropin-releasing hormone agonists(GnRH-a),combined with human chorionic gonadotropin(hCG)and hCG single trigger in high ovarian responders during in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI)treatment cycles.Methods The clinical data of 260 patients who underwent IVF/ICSI and whole embryo freezing due to high ovarian response in Maternal&Child Health Hospital of Guangxi Zhuang Autonomous Region from January 2019 to June 2022 were retrospectively collected.Among them,patients using double trigger were classified to Group A(n =131),patients using hCG single trigger were classified to Group B(n = 129).The differences in clinical indicators such as 2 pronucleus(2PN)fertilization rate,high-quality embryo rate in the fresh cycle between the two groups were compared and analyzed,and the differences in pregnancy outcomes in the first transfer cycle between the two groups were also compared and analyzed.Results There was no significant difference in 2PN rate,cleavage embryo rate,number of D3 available embryos,number of D3 top-quality embryos,number of D5 top-quality embryos,number of total blastocysts,blastocyst formation rate and incidence of ovarian hyperstimulation syndrome(OHSS)between two groups in fresh cycle(P＞0.05),but the number of frozen embryos in Group A was higher than that in Group B(P=0.023).The moderate to severe OHSS incidence rate in Group A and Group B was 1.52%and 2.32%,respectively,with no statistical significance(P=0.986),but there were 2 cases of moderate OHSS in Group A(1 patient was hospitalized)and 3 cases of severe OHSS in Group B(3 patient were hospitalized).There was no significant difference in biochemical pregnancy rate,clinical pregnancy rate,embryo implantation rate,ongoing pregnancy rate and live birth rate between the two groups in the first freeze-thaw embryo transfer cycle(P＞0.05).Conclusions In the GnRH antagonist regimen,the use of double trigger,hCG combined with GnRH-a,in high ovarian responders can induce follicle maturation and egg retrieval as well as hCG single trigger,without affecting the fertility treatment outcomes,and is beneficial to reduce the occurence of moderate to severe OHSS.
High ovarian responseGonadotropin-releasing hormone antagonist regimenDouble triggerIn vitro fertilization
NETL
NSTL
万方数据
维普
