Dual trigger with gonadotropin releasing hormone agonist and human chorionic gonadotropin improves live birth rates in POSEIDON group 3 and 4 expected poor responders

Abstract

Objective

Aim of this study was to evaluate the effects of dual triggering with gonadotropin releasing hormone agonist and human chorionic gonadotropin (hCG) on outcomes of fresh embryo transfers following gonadotropin antagonist cycles in POSEIDON group 3 and group 4 low prognosis women and to compare the outcomes with hCG-only triggering.

Methods

This study was conducted by retrospective analysis of patients with expected poor ovarian response (POSEIDON group 3 and 4) that underwent fresh embryo transfers following in-vitro fertilization/intracytoplasmic sperm injection cycles with either dual triggering or hCG-only triggering between January 2010 and April 2020. A total of 1068 women that underwent dual triggering and 1931 that underwent hCG-only triggering were included in the study.

Results

Number of retrieved oocytes, M2 oocytes, oocyte maturation rate, fertilization rate, obtained 2PN embryos, implantation rate, clinical pregnancy rate and live birth delivery rates were found significantly higher in dual-triggering group in comparison to hCG-only group (p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p = 0.02, p < 0.001 respectively).

Conclusion

Dual trigger with concomitant injections of GnRH agonist and hCG in GnRH antagonist cycles appears to improve IVF outcomes, increase quality of embryos, reduce miscarriage rates and consequently increase live birth delivery rates in POSEIDON groups 3/4 poor responders.

摘要

目的

本研究的目的是评估促性腺激素释放激素激动剂和人绒毛膜促性腺激素 (hCG) 双重扳机对波赛冬组 3 和组 4 预期卵巢低反应女性促性腺激素拮抗剂方案新鲜胚胎移植结果的影响, 并与单用 hCG 扳机进行比较。

方法

本研究回顾性分析2010 年 1 月至2020 年 4 月进行体外受精/胞浆内精子注射后新鲜胚胎移植的预期卵巢低反应（波赛冬3组和4组）患者, 比较双重扳机或单用hCG扳机。共纳入1068例双重扳机和1931例单用hCG 扳机。

结果

双重扳机组的取卵数、M2 卵母细胞、卵母细胞成熟率、受精率、2PN胚胎获取数、着床率、临床妊娠率和活产率显著高于单用hCG扳机组（p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p = 0.02, p < 0.001）。

结论

在 GnRH 拮抗剂周期中联用GnRH 激动剂和 hCG双重扳机似乎可以改善 IVF 结局, 提高胚胎质量, 降低流产率, 从而提高波赛冬3组和4组预期卵巢低反应患者的活产率。

Keywords:

• Dual trigger
• infertility
• live birth rate
• POSEIDON
• poor responder

关键词:

• 双重扳机
• 不孕
• 活产率
• 波塞冬
• 低反应

Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

The author(s) reported there is no funding associated with the work featured in this article.