Dual Trigger Compared with Human Chorionic Gonadotropin Alone and Effects on Clinical Outcome of Intracytoplasmic Sperm Injection

Background: This study compared outcomes of the standard 6000 IU human chorionic gonadotropin (hCG) trigger witha dual trigger comprised of 6000 IU hCG and 1 mg leuprolide acetate for final oocyte maturation in an intracyto plasmic sperm injection (ICSI) cycle. By convention, ICSI was performed in most cases at the clinic. Materials and Methods: : In this retrospective study, a total of 50 women were included in each arm. Participants were matched for age, indication and number of prior assisted reproduction technology (ART) cycles. Women at risk for ovarian hyperstimulation syndrome (OHSS) were excluded. A flexible gonadotropin releasing hormone (GnRH) antagonist protocol was used and final oocyte maturation was triggered when two leading follicles were 17 mm. Distribution of variables was evaluated visually withhistograms. Continuous variables were defined by mean (stand ard deviation) or median (25^th-75^th percentile) depending on distribution characteristics. Categorical variables were defined by numbers and percentages. Continuous variables were compared between the groups withthe t test or Mann Whitney U test as appropriate. Categorical variables were compared by the chi-square test and its derivatives as appropriate. A twosided P 0.05 indicated statistical significance. Results: Bothgroups had similar antral follicle counts, median parity (0) and number of previous failed cycles (0). The median number of oocytes (8 vs. 7), metaphasetwo oocytes (6 vs. 5.5), blastocysts (1 vs. 1), clinical pregnancy rates (CPR) (28% vs. 22%), ongoing pregnancy rates (OPR) (22% vs. 20%) and pregnancy rate per transfer (53.3% vs 53.8%) were similar between the dual trigger and hCG only groups, respectively. Conclusion: Dual trigger for oocyte maturation stimulation failed to improve the ICSI outcome.