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  • Title: Dual trigger of oocyte maturation with gonadotropin-releasing hormone agonist and low-dose human chorionic gonadotropin to optimize live birth rates in high responders.
    Author: Griffin D, Benadiva C, Kummer N, Budinetz T, Nulsen J, Engmann L.
    Journal: Fertil Steril; 2012 Jun; 97(6):1316-20. PubMed ID: 22480822.
    Abstract:
    OBJECTIVE: To compare live birth rates after dual trigger of oocyte maturation with GnRH agonist (GnRHa) and low-dose hCG versus GnRHa alone in high responders with peak E(2) <4,000 pg/mL at risk of ovarian hyperstimulation syndrome (OHSS). DESIGN: Retrospective cohort study. SETTING: University-based tertiary-care fertility center. PATIENT(S): Patients <40 years old with peak E(2) <4,000 pg/mL at risk of OHSS who underwent IVF/intracytoplasmic sperm injection with GnRH antagonist protocol and triggered with GnRHa alone or GnRHa plus 1,000 IU hCG (dual trigger) for oocyte maturation. INTERVENTION(S): GnRHa alone versus dual trigger. MAIN OUTCOME MEASURE(S): Live birth, implantation, and clinical pregnancy rates and OHSS. RESULT(S): The dual-trigger group had a significantly higher live birth rate (52.9% vs. 30.9%), implantation rate (41.9% vs. 22.1%), and clinical pregnancy rate (58.8% vs. 36.8%) compared with the GnRHa trigger group. One case of mild OHSS occurred in the dual-trigger group, and there were no cases of OHSS in the GnRHa trigger group. CONCLUSION(S): Dual trigger of oocyte maturation with GnRHa and low-dose hCG in high responders with peak E(2) <4,000 pg/mL improves the probability of conception and live birth without increasing the risk of significant OHSS.
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