DUAL TRIGGER COMPARED WITH HUMAN CHORIONIC GONADOTROPIN ALONE AND EFFECTS ON CLINICAL OUTCOME OF INTRA CYTOPLASMIC SPERM INJECTION

Objective: This retrospective study compared outcomes of the standard 6,000 IU hCG trigger with a dual trigger comprised of 6,000 IU hCG and 1 mg leuprolide acetate for final oocyte maturation in intracytoplasmic sperm injection (ICSI) cycle. By convetion ICSI has been performed in almost all cases at the clinic. Materials & Methods: Fifty women were included in each arm. They were matched for age, indication and the number of prior ART cycles. Women at risk for ovarian hyperstimulation syndrome were excluded. A flexible GnRH antagonist protocol was used and final oocyte maturation was triggered when two leading follicles were >17mm. Distribution of variables was evaluated visually with histograms. Continuous variables were defined with mean (standard deviation) or median (25th – 75th percentile) depending on distribution characteristics. Categorical variables were defined with numbers and percentages. Continuous variables were compared between the groups with t- test or Mann Whitney U test as appropriate. Categorical variables were compared with chi-square test and its derivatives as appropriate. A two-sided p value Results: Antral follicle count, median parity (0) and number of previous failed cycles (0) were similar between the two groups. Median number of oocytes (8 vs. 7), metaphase-two oocytes (6 vs 5.5), blastocysts (1 vs 1), clinical pregnancy rates (28% vs. 22%), ongoing pregnancy rates (22% vs. 20%) and pregnancy rate per transfer (53.3% vs 53.8%) were similar between dual trigger and hCG only groups, respectively. Conclusion: Dual trigger for oocyte maturation stimulation failed to improve outcomes of ICSI.