title: Adjuvant gonadotrophin-releasing hormone agonist trigger with human chorionic gonadotrophin to enhance ooplasmic maturity.
abstract: This study investigates whether an adjuvant gonadotrophin-releasing hormone agonist (GnRHa) trigger with human chorionic gonadotrophin (HCG) improves fresh intracytoplasmic sperm injection (ICSI) cycle outcomes in patients with poor fertilization history after standard HCG trigger alone. This study compared 156 patients with <40% fertilization rate in a prior ICSI cycle with standard HCG trigger who underwent another ICSI cycle with a combined 2 mg GnRHa and 1500 IU HCG ovulatory trigger. There was no difference in the baseline demographics, ovarian stimulation outcomes or sperm parameters of the groups. More mature oocytes were retrieved in the combined trigger group compared with the HCG trigger group: 12 (9-14) versus 10 (7-12); P = 0.01. The fertilization rate in the combined trigger group (59.2%) was higher than the HCG group (35.3%); P = 0.01. The odds of clinical pregnancy and live birth were 1.8 and 1.7 times higher, respectively, when comparing the former group to the latter; P = 0.03. The results suggest that combined GnRHa and HCG trigger in ICSI cycles is a reasonable approach to increase oocyte maturity, specifically ooplasmic maturity, thereby increasing fertilization and improving ICSI cycle outcomes in patients with a history of poor fertilization after standard HCG trigger alone.
authors: Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical Center, New York, NY. Electronic address: nip9060@med.cornell.edu.
authors: Nigel
authors: N
authors: Pereira
authors: Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical Center, New York, NY.
authors: Rony T
authors: RT
authors: Elias
authors: Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical Center, New York, NY.
authors: Queenie V
authors: QV
authors: Neri
authors: Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY.
authors: Rachel S
authors: RS
authors: Gerber
authors: Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical Center, New York, NY.
authors: Jovana P
authors: JP
authors: Lekovich
authors: Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical Center, New York, NY.
authors: Gianpiero D
authors: GD
authors: Palermo
authors: Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical Center, New York, NY.
authors: Zev
authors: Z
authors: Rosenwaks
mesh_terms: D000328:Adult; D017024:Chemotherapy, Adjuvant; D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D005306:Fertilization; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D009865:Oocytes / Q000166:cytology / Q000187:drug effects* / Q000254:growth & development; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D018873:Pregnancy Rate; D020554:Sperm Injections, Intracytoplasmic
chemical_list: D006063:Chorionic Gonadotropin; D007987:Gonadotropin-Releasing Hormone
keywords: ICSI; dual trigger; fertilization rate; gonadotrophin-releasing hormone agonist trigger; oocyte maturity