Dual trigger with gonadotropin-releasing hormone agonist and hCG to improve oocyte maturation rate

Objective. - This study investigates dual trigger with GnRHa and hCG as a potential treatment in patients with a history of >= 25 % immature oocytes retrieved in IVF/ICSI cycles. Methods. - This is a retrospective case-control study performed between October 2008 and December 2017. Forty-seven patients who experienced high oocyte immaturity rate (>= 25 %) during their first IVF/ICSI cycle (analyzed as control group) and received a dual trigger for their subsequent cycle, were involved. During dual trigger cycles, patients received antagonist protocol and ovulation triggering using triptorelin 0.2 mg and hCG. Primary endpoint was maturation rate (MR). Secondary endpoints were fertilization, D2 top quality embryo (TQE) rates, clinical pregnancy rate per fresh embryo transfer and cumulative clinical pregnancy rate per couple. Results. A significant increase in MR was achieved in case of dual trigger (71.0 %) when compared to control group (47.8 %; P < 0.0001). Moreover, cumulative clinical pregnancy rate yielded 46.8 % in dual trigger group, which was statistically higher than 27.6 % obtained in control group (P = 0.05). However, fertilization, D2 TQE rates and clinical pregnancy rates/transfer were statistically similar when compared between the two groups. Conclusion. Dual trigger seems efficient for managing patients with high oocyte immaturity rate. (C) 2019 Published by Elsevier Masson SAS.