COMPARING TWO PROTOCOLS FOR FINAL OOCYTE MATURATION IN POOR RESPONDERS UNDERGOING GnRH-ANTAGONIST ICSI CYCLES

Abstract

Background: Poor ovarian responders (POR) include a significant proportion of women referred for IVF treatments (ranging from 9 to 24 %), most of whom are in late reproductive age. Attempts to improve IVF cycle outcomes for poor responders. Final oocyte maturation trigger is one of the most important key success factors in assisted reproductive technologies (ARTs). The authors in this study sought to investigate the role of daual trigger in final oocyte maturation in poor responders undergoing  GnRH-antagonist ICSI cycles.

Methods: A prospective randomized controlled trial conducted on 160 poor ovarian responders indicated for ICSI using a GnRH‐antagonist protocol. They were randomized to either group A or group B.Group A received 10000 IU of hCG (Choriomon5000 IU; IBSA) given intramuscularly while group B received 10000 IU of hCG (Choriomon5000 IU; IBSA) intramuscular injection in addition to the GnRH agonist triptorelin 0.2 mg (Decapeptyl 0.1 mg; Ferring) subcutaneously for triggering of ovulation. The primary outcome parameter was the number of metaphase II oocytes retrieved. Secondary outcomes included the total number of oocytes, ratio between number of follicles seen on day of trigger and number of oocytes retrieved, maturity index, fertilization rate.

Results: Dual trigger was associated with higher number of fertilized oocytes (3.3±1.81 vs. 3.92±1.90, p=0.039) , fertilization rate (80.82±23.04 vs 91.86±15.62, p=0.002)  and maturity index (81.5% vs 86.9%, p=0.043). There were no significant differences in terms of number of number of oocytes retrieved, FOI % and number of metaphase 2 oocytes.

Conclusion: Dual trigger was associated with better oocyte competence in poor responders compared with single trigger.

K E Y W O R D S

Dual trigger; GnRH‐antagonist protocol; ICSI; Poor responders