Nan Ding1, Xingchen Liu1, Qiliang Jian1, Zhongzhen Liang1, Fang Wang2. 1. Reproductive Medicine Center, Lanzhou University Second Hospital, Gansu, Lanzhou City, 730030, China. 2. Reproductive Medicine Center, Lanzhou University Second Hospital, Gansu, Lanzhou City, 730030, China. Electronic address: wangfang4323@126.com.
Abstract
OBJECTIVE: Increasing evidence indicates that a dual trigger (a gonadotrophin-releasing hormone agonist [GnRH-a] with a human chorionic gonadotrophin [hCG] trigger) is the best choice for final oocyte maturation in the GnRH antagonist (GnRH-ant) cycle. However, this conclusion remains controversial. Therefore, we performed this meta-analysis to systematically evaluate the efficacy of a GnRH-a combined with a standard hCG trigger in comparison with hCG alone for final oocyte maturation in the GnRH-ant cycle for in vitro fertilization. STUDY DESIGN: Complete electronic databases, including PubMed, Embase, The Cochrane Library, and Web of Science, were searched for relevant randomized controlled trials (RCT). The search was not restricted by language or publication time. Two reviewers selected trials and assessed trial quality independently by using the Cochrane Handbook 5.1.0. RESULTS: Four eligible RCT studies involving 527 women were included. The results of this meta-analysis indicated that the dual trigger group had a significantly higher pregnancy rate (relative risk [RR], 1.55; 95% confidence interval [CI], 1.17-2.06) than the hCG-only trigger group. No significant differences were found in the number of oocytes retrieved (weighted mean difference [WMD], 0.47; 95% CI, -0.42 to 1.37), number of mature oocytes retrieved (WMD, 0.41; 95% CI, -0.48 to 1.30), number of fertilized oocytes (WMD, 0.47; 95% CI, -0.32 to 1.26), number of good-quality embryos (WMD, 0.17; 95% CI, -0.29 to 0.64), or implantation rate (RR, 1.17; 95% CI, 0.69-2.00) between the two groups. CONCLUSION: GnRH-a and hCG as dual trigger was equivalent to hCG in triggering oocyte maturation and may be beneficial in improving reproductive outcomes. Further intensive randomized-controlled studies should be conducted to investigate the efficacy of the dual trigger.
OBJECTIVE: Increasing evidence indicates that a dual trigger (a gonadotrophin-releasing hormone agonist [GnRH-a] with a human chorionic gonadotrophin [hCG] trigger) is the best choice for final oocyte maturation in the GnRH antagonist (GnRH-ant) cycle. However, this conclusion remains controversial. Therefore, we performed this meta-analysis to systematically evaluate the efficacy of a GnRH-a combined with a standard hCG trigger in comparison with hCG alone for final oocyte maturation in the GnRH-ant cycle for in vitro fertilization. STUDY DESIGN: Complete electronic databases, including PubMed, Embase, The Cochrane Library, and Web of Science, were searched for relevant randomized controlled trials (RCT). The search was not restricted by language or publication time. Two reviewers selected trials and assessed trial quality independently by using the Cochrane Handbook 5.1.0. RESULTS: Four eligible RCT studies involving 527 women were included. The results of this meta-analysis indicated that the dual trigger group had a significantly higher pregnancy rate (relative risk [RR], 1.55; 95% confidence interval [CI], 1.17-2.06) than the hCG-only trigger group. No significant differences were found in the number of oocytes retrieved (weighted mean difference [WMD], 0.47; 95% CI, -0.42 to 1.37), number of mature oocytes retrieved (WMD, 0.41; 95% CI, -0.48 to 1.30), number of fertilized oocytes (WMD, 0.47; 95% CI, -0.32 to 1.26), number of good-quality embryos (WMD, 0.17; 95% CI, -0.29 to 0.64), or implantation rate (RR, 1.17; 95% CI, 0.69-2.00) between the two groups. CONCLUSION:GnRH-a and hCG as dual trigger was equivalent to hCG in triggering oocyte maturation and may be beneficial in improving reproductive outcomes. Further intensive randomized-controlled studies should be conducted to investigate the efficacy of the dual trigger.
Authors: Condesmar M de Oliveira; Carlos A M de Oliveira; Larissa L Fonseca; Kelly R R de Souza; Moacir R M Radaelli Journal: JBRA Assist Reprod Date: 2021-04-27
Authors: Min Kyu Kang; Min Kyoung Kim; Tae Hyung Kim; Ji Won Kim; Eun Mi Chang; Sang Woo Lyu; Jin Young Kim; Woo Sik Lee Journal: Obstet Gynecol Sci Date: 2022-01-26
Authors: The Eshre Guideline Group On Ovarian Stimulation; Ernesto Bosch; Simone Broer; Georg Griesinger; Michael Grynberg; Peter Humaidan; Estratios Kolibianakis; Michal Kunicki; Antonio La Marca; George Lainas; Nathalie Le Clef; Nathalie Massin; Sebastiaan Mastenbroek; Nikolaos Polyzos; Sesh Kamal Sunkara; Tanya Timeva; Mira Töyli; Janos Urbancsek; Nathalie Vermeulen; Frank Broekmans Journal: Hum Reprod Open Date: 2020-05-01
Authors: Raoul Orvieto; Christos A Venetis; Human M Fatemi; Thomas D'Hooghe; Robert Fischer; Yulia Koloda; Marcos Horton; Michael Grynberg; Salvatore Longobardi; Sandro C Esteves; Sesh K Sunkara; Yuan Li; Carlo Alviggi Journal: Front Endocrinol (Lausanne) Date: 2021-05-10 Impact factor: 5.555