title: 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.
abstract: OBJECTIVE
  To investigate whether dual triggering of final oocyte maturation with a combination of gonadotropin-releasing hormone (GnRH) agonist and human chorionic gonadotropin (hCG) can improve the live-birth rate for normal responders in GnRH-antagonist in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI) cycles.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Infertility unit of a university-affiliated medical center.
  
  
  METHODS
  Normal responders to controlled ovarian hyperstimulation who were undergoing IVF-ICSI with a GnRH antagonist protocol.
  
  
  METHODS
  Standard dosage of hCG trigger (6,500 IU of recombinant hCG) versus dual trigger (0.2 mg of triptorelin and 6,500 IU of recombinant hCG).
  
  
  METHODS
  Live-birth, clinical pregnancy, and implantation rates per cycle.
  
  
  RESULTS
  A total of 376 patients with 378 completed cycles with embryo transfer were enrolled (hCG trigger/control group: n = 187; dual trigger/study group: n = 191). The dual trigger group demonstrated statistically significantly higher implantation (29.6% vs. 18.4%), clinical pregnancy (50.7% vs. 40.1%), and live-birth (41.3% vs. 30.4%) rates as compared with the hCG trigger group. There was no statistically significant difference in terms of patient demographics, cycle parameters, or embryo quality.
  
  
  CONCLUSIONS
  Dual trigger of final oocyte maturation with a GnRH-agonist and a standard dosage of hCG in normal responders statistically significantly improves implantation, clinical pregnancy, and live-birth rates in GnRH-antagonist IVF cycles.
authors.affiliation: Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing, and Management College, Taipei, Taiwan.
authors.forename: Ming-Huei
authors.initials: MH
authors.lastname: Lin
authors.forename: Frank Shao-Ying
authors.initials: FS
authors.lastname: Wu
authors.forename: Robert Kuo-Kuang
authors.initials: RK
authors.lastname: Lee
authors.forename: Sheng-Hsiang
authors.initials: SH
authors.lastname: Li
authors.forename: Shyr-Yeu
authors.initials: SY
authors.lastname: Lin
authors.forename: Yuh-Ming
authors.initials: YM
authors.lastname: Hwu
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D016009:Chi-Square Distribution; D006063:Chorionic Gonadotropin / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000378:metabolism; D006801:Humans; D050498:Live Birth; D054315:Oocyte Retrieval; D010053:Ovary / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D010060:Ovulation / Q000187:drug effects*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011994:Recombinant Proteins / Q000008:administration & dosage; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D016896:Treatment Outcome; D017329:Triptorelin Pamoate / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D011994:Recombinant Proteins; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone
keywords: Dual trigger; GnRH agonist; GnRH antagonist; normal responders