#50 : Effect of Dual vs. Single (hCG) Trigger in Maturation Rate of Oocytes in ART
Background and Aims: Due to its similar molecular structures and biological activities, human chorionic gonadotropin (hCG) is used as a substitute for luteinizing hormone (LH) in ART. The weaknesses of using hCG as a trigger are the possibility of ovarian hyperstimulation syndrome in high responders...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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World Scientific Publishing
2023-12-01
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| Series: | Fertility & Reproduction |
| Online Access: | https://www.worldscientific.com/doi/10.1142/S2661318223743837 |
| _version_ | 1797237059905126400 |
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| author | Liva Wijaya Nadia Shafira Boy Abidin Ayang Halim Tri Bowo Hasmoro Budi Wiweko |
| author_facet | Liva Wijaya Nadia Shafira Boy Abidin Ayang Halim Tri Bowo Hasmoro Budi Wiweko |
| author_sort | Liva Wijaya |
| collection | DOAJ |
| description | Background and Aims: Due to its similar molecular structures and biological activities, human chorionic gonadotropin (hCG) is used as a substitute for luteinizing hormone (LH) in ART. The weaknesses of using hCG as a trigger are the possibility of ovarian hyperstimulation syndrome in high responders and lacked FSH activity which promotes LH receptor formation in luteinizing granulosa cells, nuclear maturation, and cumulus expansion. GnRH agonist (GnRHa) reduces the development of OHSS and induces a physiological surge similar to the natural menstrual cycle. Because of shorter amplitude and duration of GnRHa-induced LH surge, GnRHa-alone trigger results in a higher early miscarriage rate. Combining these two agents; dual trigger increases oocyte maturation with reduced OHSS. Here we present reports in our clinic to differentiate the dual vs. hCG trigger results. Method: We retrospectively analyzed the data from 68 patients who had undergone antagonist protocol from January 2021-January 2023. The final oocyte maturation was undertaken with a dual trigger with GnRHa (Buserelin 0.3 mg) combined with hCG (r-hCG 250 [Formula: see text]g) ([Formula: see text] = 33) or hCG alone ([Formula: see text] = 35). Results: The mean age of both groups was 34 years old. The AMH level of the dual group ranged from 0.06 – 7.17 ng/mL, and in hCG alone group ranged from 0.16 – 12.3 ng/mL. Women in both groups got similar amounts of follicles and MII oocytes; dual group (14.8 and 12.72 vs. 14.9 and 13). The retrieval rate of oocytes was identical in both groups (86.6% vs. 89.9%). However, the maturation rate of dual group was slightly lower than the hCG group (77% vs. 82%), but it was statistically insignificant (independent t-test p 0.99). Conclusion: We showed that dual trigger was not superior to hCG-alone trigger in terms of maturation rate of oocytes. Analysis of larger data is needed to show the real advantages. |
| first_indexed | 2024-04-24T17:13:44Z |
| format | Article |
| id | doaj.art-570226ed8b744776952e4a92dcd3b286 |
| institution | Directory Open Access Journal |
| issn | 2661-3182 2661-3174 |
| language | English |
| last_indexed | 2024-04-24T17:13:44Z |
| publishDate | 2023-12-01 |
| publisher | World Scientific Publishing |
| record_format | Article |
| series | Fertility & Reproduction |
| spelling | doaj.art-570226ed8b744776952e4a92dcd3b2862024-03-28T07:54:18ZengWorld Scientific PublishingFertility & Reproduction2661-31822661-31742023-12-01050466166110.1142/S2661318223743837#50 : Effect of Dual vs. Single (hCG) Trigger in Maturation Rate of Oocytes in ARTLiva Wijaya0Nadia Shafira1Boy Abidin2Ayang Halim3Tri Bowo Hasmoro4Budi Wiweko5Mbrio IVF Clinic, Mitra Keluarga Kelapa Gading Hospital, Jakarta, IndonesiaMbrio IVF Clinic, Mitra Keluarga Kelapa Gading Hospital, Jakarta, IndonesiaMbrio IVF Clinic, Mitra Keluarga Kelapa Gading Hospital, Jakarta, IndonesiaMbrio IVF Clinic, Mitra Keluarga Kelapa Gading Hospital, Jakarta, IndonesiaMbrio IVF Clinic, Mitra Keluarga Kelapa Gading Hospital, Jakarta, IndonesiaMbrio IVF Clinic, Mitra Keluarga Kelapa Gading Hospital, Jakarta, IndonesiaBackground and Aims: Due to its similar molecular structures and biological activities, human chorionic gonadotropin (hCG) is used as a substitute for luteinizing hormone (LH) in ART. The weaknesses of using hCG as a trigger are the possibility of ovarian hyperstimulation syndrome in high responders and lacked FSH activity which promotes LH receptor formation in luteinizing granulosa cells, nuclear maturation, and cumulus expansion. GnRH agonist (GnRHa) reduces the development of OHSS and induces a physiological surge similar to the natural menstrual cycle. Because of shorter amplitude and duration of GnRHa-induced LH surge, GnRHa-alone trigger results in a higher early miscarriage rate. Combining these two agents; dual trigger increases oocyte maturation with reduced OHSS. Here we present reports in our clinic to differentiate the dual vs. hCG trigger results. Method: We retrospectively analyzed the data from 68 patients who had undergone antagonist protocol from January 2021-January 2023. The final oocyte maturation was undertaken with a dual trigger with GnRHa (Buserelin 0.3 mg) combined with hCG (r-hCG 250 [Formula: see text]g) ([Formula: see text] = 33) or hCG alone ([Formula: see text] = 35). Results: The mean age of both groups was 34 years old. The AMH level of the dual group ranged from 0.06 – 7.17 ng/mL, and in hCG alone group ranged from 0.16 – 12.3 ng/mL. Women in both groups got similar amounts of follicles and MII oocytes; dual group (14.8 and 12.72 vs. 14.9 and 13). The retrieval rate of oocytes was identical in both groups (86.6% vs. 89.9%). However, the maturation rate of dual group was slightly lower than the hCG group (77% vs. 82%), but it was statistically insignificant (independent t-test p 0.99). Conclusion: We showed that dual trigger was not superior to hCG-alone trigger in terms of maturation rate of oocytes. Analysis of larger data is needed to show the real advantages.https://www.worldscientific.com/doi/10.1142/S2661318223743837 |
| spellingShingle | Liva Wijaya Nadia Shafira Boy Abidin Ayang Halim Tri Bowo Hasmoro Budi Wiweko #50 : Effect of Dual vs. Single (hCG) Trigger in Maturation Rate of Oocytes in ART Fertility & Reproduction |
| title | #50 : Effect of Dual vs. Single (hCG) Trigger in Maturation Rate of Oocytes in ART |
| title_full | #50 : Effect of Dual vs. Single (hCG) Trigger in Maturation Rate of Oocytes in ART |
| title_fullStr | #50 : Effect of Dual vs. Single (hCG) Trigger in Maturation Rate of Oocytes in ART |
| title_full_unstemmed | #50 : Effect of Dual vs. Single (hCG) Trigger in Maturation Rate of Oocytes in ART |
| title_short | #50 : Effect of Dual vs. Single (hCG) Trigger in Maturation Rate of Oocytes in ART |
| title_sort | 50 effect of dual vs single hcg trigger in maturation rate of oocytes in art |
| url | https://www.worldscientific.com/doi/10.1142/S2661318223743837 |
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