Dual trigger with gonadotropin-releasing hormone agonist and recombinant human chorionic gonadotropin improves the outcome of intrauterine insemination
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Objective: The objective of this study was to evaluate the effectiveness of dual trigger, which is a combination of gonadotropinreleasing agonist (GnRH-a) and recombinant human chorionic gonadotropin (hCG) in the final oocyte maturation, in the outcome of intrauterine insemination (IUI). Methods: This retrospective observational study was conducted from January 2016 to October 2018 and involved 639 IUI cycles at the Halim Fertility Center, Indonesia. Controlled ovarian stimulation was performed during IUI cycles. The ovulation triggers were divided into two groups: group I received a combination of GnRH-a and recombinant hCG as a dual trigger, and group II received only recombinant hCG as a single trigger. The baseline characteristics, cycle parameters, and IUI outcomes of both groups were compared. Results: Our study included a total of 639 IUI cycles, 334 were in the dual trigger group and 305 in the single trigger group. The clinical pregnancy rates were significantly higher in the dual trigger group than in the single trigger group (P<0.001). Based on the multivariate analysis, the dual trigger increased the clinical pregnancy rate by 2.524 times than that by the single trigger. Conclusion: Our data showed that the dual trigger combination of GnRH-a and recombinant hCG significantly improves the outcome of intrauterine insemination.
Abstract
Objective: The objective of this study was to evaluate the effectiveness of dual trigger, which is a combination of gonadotropinreleasing agonist (GnRH-a) and recombinant human chorionic gonadotropin (hCG) in the final oocyte maturation, in the outcome of intrauterine insemination (IUI). Methods: This retrospective observational study was conducted from January 2016 to October 2018 and involved 639 IUI cycles at the Halim Fertility Center, Indonesia. Controlled ovarian stimulation was performed during IUI cycles. The ovulation triggers were divided into two groups: group I received a combination of GnRH-a and recombinant hCG as a dual trigger, and group II received only recombinant hCG as a single trigger. The baseline characteristics, cycle parameters, and IUI outcomes of both groups were compared. Results: Our study included a total of 639 IUI cycles, 334 were in the dual trigger group and 305 in the single trigger group. The clinical pregnancy rates were significantly higher in the dual trigger group than in the single trigger group (P<0.001). Based on the multivariate analysis, the dual trigger increased the clinical pregnancy rate by 2.524 times than that by the single trigger. Conclusion: Our data showed that the dual trigger combination of GnRH-a and recombinant hCG significantly improves the outcome of intrauterine insemination.
참고문헌 (25)
- Soliman BS, "Pregnancy rate after ovulation triggering with gonadotrophin releasing hormone agonist versus human chorionic gonadotrophin in women undergoing controlled ovarian stimulation", intrauterine insemination, 2014, pp.19, 262~267
- Weiss A, "A randomized trial comparing time intervals from HCG trigger to intrauterine insemination for cycles utilizing GnRH antagonists", Syst Biol Reprod Med, 61, pp.44~49 (2015)
- Le MT, "GnRH agonist versus hCG trigger in ovulation induction with intrauterine insemination : a randomized controlled trial", Int J Endocrinol (2019)[DOI]
- Farag AH, "Triggering ovulation with gonadotropin-releasing hormone agonist versus human chorionic gonadotropin in polycystic ovarian syndrome. A randomized trial", Middle East Fertil Soc J, 20, pp.217~223 (2015)
- Lee JI, "Comparison of pregnancy rates by intrauterine insemination after ovulation trigger with endogenous LH surge, GnRH agonist or hCG in stimulated cycles", Clin Exp Reprod Med, 26, pp.389~398 (1999)
- Taheripanah R, "Comparing the effect of gonadotropin-releasing hormone agonist and human chorionic gonadotropin on final oocytes for ovulation triggering among infertile women undergoing intrauterine insemination : An RCT", Int J Reprod Biomed, 15, pp.351~356 (2017)
- Andersen AG, "Time interval from human chorionic gonadotrophin(HCG)injection to follicular rupture", Hum Reprod, 10, pp.3202~3205 (1995)
- Lin MH, "Dual trigger with combination of gonadotropin-releasing hormone agonist and human chorionic gonadotropin significantly improves the live-birth rate for normal responders in GnRH-antagonist cycles", Fertil Steril, 100, pp.1296~1302 (2013)
- Griffin D, "Dual trigger with gonadotropin-releasing hormone agonist and standard dose human chorionic gonadotropin to improve oocyte maturity rates", Fertil Steril, 102, pp.405~409 (2014)
- Fabris AM, "Dual triggering with gonadotropinreleasing hormone agonist and standard dose human chorionic gonadotropin in patients with a high immature oocyte rate", Reprod Sci, 24, pp.1221~1225 (2017)
- Mahajan N, "Evaluation of dual trigger with gonadotropin-releasing hormone agonist and human chorionic gonadotropin in improving oocyte maturity rates : a prospective randomized study", J Hum Reprod Sci, 9, pp.101~106 (2016)
- Zhang J, "Dual trigger of final oocyte maturation in poor ovarian responders undergoing IVF", ICSI cycles, 2017, pp.35, 701~707
- Li S, "Dual trigger of triptorelin and HCG optimizes clinical outcome for high ovarian responder in GnRH-antagonist protocols", Oncotarget, 9, pp.5337~5343 (2018)
- Chen CH, "Dual triggering with GnRH agonist plus hCG versus triggering with hCG alone for IVF", ICSI outcome in GnRH antagonist cycles : a systematic review and meta-analysis, 2018, pp.298, 17~26
- Ding N, "Dual trigger of final oocyte maturation with a combination of GnRH agonist and hCG versus a hCG alone trigger in GnRH antagonist cycle for in vitro fertilization : a systematic review and meta-analysis", Eur J Obstet Gynecol Reprod Biol, 218, pp.92~98 (2017)
- Kol S, "GnRH agonist triggering : recent developments", Reprod Biomed Online, 26, pp.226~230 (2013)
- Youssef MA, "Gonadotropinreleasing hormone agonist versus HCG for oocyte triggering in antagonist-assisted reproductive technology", Cochrane Database Syst Rev, (10), pp.CD008046~ (2014)
- Orvieto R, "Triggering final follicular maturation-hCG, GnRH-agonist or both, when and to whom?", J Ovarian Res, 8, pp.60~ (2015)
- Humaidan P, "GnRH agonist(buserelin)or hCG for ovulation induction in GnRH antagonist IVF", ICSI cycles : a prospective randomized study, 2005, pp.20, 1213~1220
- Viviane Margareth Scantamburlo, "Association between decreased ovarian reserve and poor oocyte quality", Obstetrics & Gynecology Science, 64(6), pp.532~539 (2021), 대한산부인과학회
- Haas J, "Co-administration of GnRH-agonist and hCG for final oocyte maturation(double trigger)in patients with low number of oocytes retrieved per number of preovulatory follicles--a preliminary report", J Ovarian Res, 7, pp.77~ (2014)
- Zilberberg E, "Co-administration of GnRH-agonist and hCG, for final oocyte maturation(double trigger), in patients with low proportion of mature oocytes", Gynecol Endocrinol, 31, pp.145~147 (2015)
- Alyasin A, "GnRH agonist trigger versus hCG trigger in GnRH antagonist in IVF", ICSI cycles : a review article, 2016, pp.14, 557~566
- Conghui Liu, "The clinical outcomes of fresh versus frozen embryos transfer in women ≥40 years with poor ovarian response", Obstetrics & Gynecology Science, 64(3), pp.284~292 (2021), 대한산부인과학회[DOI]
- AboulGheit S, "Pregnancy rates following three different timings of intrauterine insemination for women with unexplained infertility : a randomised controlled trial", Middle East Fertil Soc J, 15, pp.265~268 (2010)
