Comparison of Ovulation Triggering Outcomes by Standard Dose of hCG versus Declined hCG Dose With GnRH Agonist in Antagonist Cycles: A Randomized Clinical Trial

Abstract

Objectives: Today, infertility is a global complication affecting 8%-12% of couples. The use of assisted reproductive techniques (ARTs) gives couples to have taken the home baby chance. In this study, we compare the outcomes of the ARTs after using the standard dose of human chorionic gonadotropin (hCG) hormone and gonadotropin-releasing hormone (GnRh) agonist plus declined dose of hCG for final oocyte maturation in antagonist cycles. Materials and Methods: This randomized clinical trial was conducted in Al-Zahra hospital, Tabriz, Iran from June to December 2019 on 100 infertile women who were candidate for in vitro fertilization in two groups: group A received standard dose of hCG and group B received GnRH agonist 0.2 mg and hCG 2500 international unit as dual trigger. The number of oocytes retrieved, embryo obtained, implantation rate, pregnancy rate, and ovarian hyperstimulation syndrome (OHSS) were compared between two groups. Results: The number of retrieved oocytes in the group B was more than group A (P=0.024), and the embryo obtained in both groups was similar. The implantation and pregnancy rate in the group B increased compared to group A (P= 0.001). There was no OHSS case in the group B, while in the group A two cases suffered from OHSS. Conclusions: Dual trigger with GnRH agonist plus declined hCG dose increased the number of retrieved oocytes, implantation, and pregnancy rates and decreased the risk of OHSS compared to standard hCG trigger. The gynecologists should select the best strategy based on the patient’s condition.