A comparison of Dual triggering by administration of Gonadotropin releasing hormon agonist plus human chorionic gonadotropin versus HCG in normal responders at assisted reproductive programs outcome

The aim of this study was to evaluate the effect of dual triggering in Art outcome.210 patients began ovarian stimulation with a flexible starting dosage of recombinant FSH (Gonal-F; Merck Serono .) ranging from 150 to 225 IU on the second day of the menstrual cycle for 5 consecutive days. Once the leading follicle had reached a size of 13 mm, co-treatment with the GnRH antagonist 0.25 mg/day, was initiated. Gonadotropins doses were further adjusted according to vaginal ultrasound measurements of follicular diameter,obtained every two or three days. When at least two leading follicles had reached 17 mm in diameter, final oocyte maturation was triggered by either 6500 I.U. hCG alone, or by 6500 IU hCG plus 0.2 mg of triptorelin (Decapeptyl; Ferring GmbH).Oocyte retrievals were performed under transvaginal ultrasound guidance 34 to 36 hours after triggering. All embryo transfers were performed 48 to72 hours after oocyte retrieval. The luteal phase was supported by daily progesterone suppositories(total dose 800mg) starting on the day of oocyte retrieval. Serum b-hCG was measured 14 days after transfer, and a value above 5 IU/mL was considered to be a positive pregnancy. The luteal support was then continued until the 10th week of gestation.The primary outcome measure was clinical pregnancy rate and the secondary outcome measures were implantation rate,chemical pregnancy , ongoing pregnancy ,OHSS rate andf abortion rate.

Yazd reserch and clinical center for infertility