Wafaa Mohammed Abed*


The aim of this study is to demonstrate the influence of the use of dual triggering (low dose hCG plus gonadotropin releasing hormone agonist) for final oocyte maturation trigger compared to conventional trigger (hCG standard dose alone) on the outcome of fresh antagonist ICSI cycle regarding embryo quality, number and grade transfer embryos, implantation and clinical pregnancy rate. Material and method: 80 infertile women included in fresh antagonist ICSI cycle, aged 18-40 years, BMI 18-30 kg/m2. On the day of trigger, 40 patients receive conventional trigger (500μg recombinant hCG) and other 40 patients receive low dose recombinant hCG (250μg) plus GnRH agonist (0.2mg treptoreline) for final oocyte maturation. Present study was conducted at the High Institute for Infertility Diagnosis and Assisted Reproductive Techniques, Al-Nahrain University. High quality embryo, total number and grade of embryo transferred, implantation rate and clinical pregnancy rate were measured . Result: The mean number of grade 1 embryo was higher and grade 3 embryos were significantly lower in the dual trigger group there was no significant difference in mean grade 2, (P=0.843) and grade 3 embryo numbers (P = 0.192) between both groups. Day 2 embryo transfer was more frequent whereas, day 3 and day 5 were less frequent in the recombinant Human chorionic gonadotropin group, the difference was significant (P=0.011), transferred grade 1 embryos were significantly more frequent in dual trigger group (P=0.012), two transferred embryos were more frequent in dual trigger group but the difference was insignificant (P=0.113).The mean implantation rate was not significant from a statistical perspective (P=0.171). The rate of clinical pregnancy was higher in the dual trigger group however, the difference did not reach statistical significance (P = 0.284). Conclusion: Results of this study indicate a significant improvement in the outcomes in fresh antagonist ICSI cycles using conventional trigger (recombinant hCG trigger) versus low dose recombinant hCG plus GnRH agonist (dual trigger) regarding the total number of grade 1 embryos, the total number and grade 1 embryos transferred, implantation and clinical pregnancy rate.

Keywords: Fresh antagonist ICSI cycle. Conventional trigger, Dual trigger, Total number transferred embryo, Implantation rate.

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