Combined ovulation triggering with GnRH agonist and hCG in IVF patients

Miro Kasum, Kristijan Kurdija, Slavko Orešković, Ermin Čehić, Dinka Pavičić-Baldani, Lana Škrgatić
2016 Gynecological Endocrinology  
Keywords: combined ovulation triggering, GnRH agonist trigger, hCG-triggering, dual trigger, double trigger The aim of the review is to analyse the combination of a gonadotrophin releasing hormone (GnRH) agonist with a human chorionic gonadotrophin (hCG) trigger, for final oocyte maturation in in vitro fertilisation (IVF) cycles. The concept being a "dual trigger"combines a single dose of the GnRH agonist with a reduced or standard dosage of hCG at the time of triggering. The use of a GnRH
more » ... use of a GnRH agonist with a reduced dose of hCG in high responders demonstrated luteal phase support with improved pregnancy rates, similar to those after conventional hCG and a low risk of ovarian hyperstimulation syndrome. The administration of a GnRH agonist and a standard hCG in normal responders, demonstrated significantly improved live-birth rates and a higher number of embryos of excellent quality, or cryopreserved embryos. The concept of the "double trigger", represents a combination of a GnRH agonist and a standard hCG, when used 40 and 34 hours prior to ovum pick-up, respectively. The use of the "double trigger" has been successfully offered in treatment of empty follicle syndrome and in patients with a history of immature oocytes retrieved or with low/poor oocytes yield. Further prospective studies are required to confirm the aforementioned observations prior to clinical implementation.
doi:10.1080/09513590.2016.1193141 pmid:27275861 fatcat:ztl3g6xmgfcwtknhspix6wwjba