Dual triggering for final oocyte maturation compared to single triggering in GnRH antagonist (IVF-ICSI) protocols (Randomized Controlled Trial)

Background: Infertility is one of the major medical problems in the world which has led to continuous researchand advances in the field of assisted reproductive technology (ART),Aim of the work: to investigate whether co-administration of GnRH-a and hCG for final oocyte maturation (dualtrigger) would improve number of oocytes retrieved& itsquality and eventually IVF/ICSI clinical outcomes compared to single triggers in women with normal ovarianresponse undergoing (IVF/ICSI) technique using GnRHantagonist protocol of stimulation.Patients and Methods: A total 120 patients were included in this study, randomized and divided into two groups:Group (1): The study group; included 60 patients who received the dual trigger. Group (2): The control group; whoincluded 60 patients, age matched, who received the hCGtrigger alone. All participants were subjected to properhistory taking, complete general, abdominal and pelvicexamination, and full investigations to confirm criteriaof the study. All participants were subjected to controlledovarian hyper stimulation protocol according to GnRHantagonist protocol starting on day 2-3 of the menstrualcycle with a starting daily administration of FSH, humanmenopausal gonadotropin hMG, or highly purified hMG,or highly purified FSH or with recombinant FSH (r.FSH)intramuscularly for 4–5 days, and continued until the dayof final oocyte maturation injection.Results: the current study showed statistically significant difference with p-value <0.05 between study groupsas regards to the number of retrieved oocytes (cases:11.42±4.2 vs. control: 9.8±4.9), number of MII oocyte retrieved (dual trigger: 6.2±2.7 vs. single trigger: 4.6±3.1),and number of fertilized oocyte (dual trigger: 4.03±2.2 vs.single trigger: 3.05±2.5) with higher mean among dualtrigger group. In the current study also the dual-triggergroup demonstrated a significantly higher percentage asregards to biochemical pregnancy rate (cases: 68.3%vs.33.3% among controls), clinical pregnancy rate (cas-