Dual trigger with combination of gonadotropin-releasing hormone agonist and human chorionic gonadotropin significantly improves the live-birth rate for normal responders in GnRH-antagonist cycles
Dual trigger with combination of gonadotropin-releasing hormone agonist and human chorionic gonadotropin significantly improves the live-birth rate for normal responders in GnRH-antagonist cycles
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DOI：
10.1016/j.fertnstert.2013.07.1976
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发表时间：
2013-11-01
影响因子：
6.7
通讯作者：
Hwu, Yuh-Ming
中科院分区：
文献类型：
--
作者：
Lin, Ming-Huei;Wu, Frank Shao-Ying;Hwu, Yuh-Ming
目的：探讨促性腺激素释放激素（GnRH）激动剂和人绒毛膜促性腺激素（hCG）联合双重触发最终卵母细胞成熟是否可以提高 GnRH 拮抗剂体外受精/胞浆内单精子注射（IVF-ICSI）中正常反应者的活产率 设计：回顾性队列研究。地点：大学附属医疗中心的不孕不育科。患者：对受控卵巢过度刺激有正常反应者，正在接受 GnRH 拮抗剂方案的 IVF-ICSI。干预措施：标准剂量的 hCG 触发剂（6,500 IU 重组 hCG）与双重触发剂（0.2 mg 曲普瑞林和 6,500 IU 重组 hCG）。主要结果指标：活产、临床妊娠和每个周期的着床率。结果：共有 376 名患者入组，完成 378 个胚胎移植周期（hCG 触发/对照组：n = 187；双触发/研究组：n = 191）。与 hCG 触发组相比，双触发组的着床率（29.6% vs. 18.4%）、临床妊娠率（50.7% vs. 40.1%）和活产率（41.3% vs. 30.4%）具有统计学意义。在患者人口统计、周期参数或胚胎质量方面没有统计学上的显着差异。结论：在正常反应者中，使用 GnRH 激动剂和标准剂量的 hCG 双重触发最终卵母细胞成熟，统计上显着改善 GnRH 拮抗剂 IVF 周期中的着床率、临床妊娠率和活产率。 (C) 2013 年，美国生殖医学会。
Objective: To investigate whether dual triggering of final oocyte maturation with a combination of gonadotropin-releasing hormone (GnRH) agonist and human chorionic gonadotropin (hCG) can improve the live-birth rate for normal responders in GnRH-antagonist in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI) cycles.Design: Retrospective cohort study.Setting: Infertility unit of a university-affiliated medical center.Patient(s): Normal responders to controlled ovarian hyperstimulation who were undergoing IVF-ICSI with a GnRH antagonist protocol.Intervention(s): Standard dosage of hCG trigger (6,500 IU of recombinant hCG) versus dual trigger (0.2 mg of triptorelin and 6,500 IU of recombinant hCG).Main Outcome Measure(s): Live-birth, clinical pregnancy, and implantation rates per cycle.Result(s): A total of 376 patients with 378 completed cycles with embryo transfer were enrolled (hCG trigger/control group: n = 187; dual trigger/study group: n = 191). The dual trigger group demonstrated statistically significantly higher implantation (29.6% vs. 18.4%), clinical pregnancy (50.7% vs. 40.1%), and live-birth (41.3% vs. 30.4%) rates as compared with the hCG trigger group. There was no statistically significant difference in terms of patient demographics, cycle parameters, or embryo quality.Conclusion(s): Dual trigger of final oocyte maturation with a GnRH-agonist and a standard dosage of hCG in normal responders statistically significantly improves implantation, clinical pregnancy, and live-birth rates in GnRH-antagonist IVF cycles. (C) 2013 by American Society for Reproductive Medicine.