A RETROSPECTIVE STUDY COMPARING OOCYTE QUALITY AND PREGNANCY OUTCOMES BETWEEN DOUBLE-DOSE(500 g), RECOMMENDED-DOSE(250 g) HCG TRIGGER VERSUS DUAL-TRIGGER(GNRH-AGONIST WITH HCG) IN ADVANCED-AGE WOMEN.

Does double-dose hCG triggering improve oocyte quality and pregnancy outcomes compared to single-dose hCG triggering and dual trigger with GnRH-Agonist with hCG in advanced-age women undergoing IVF-ICSI cycles? This retrospective study was conducted from January 2020 to October 2022 at a CHA hospital seoulstation. Women aged ≥35 years undergoing IVF/ICSI treatment, receiving a non-pituitary down-regulation protocol, and with low risk of OHSS, were included in the study. A total of 656 cycles were divided into three groups according to different trigger protocols: group A received r-hCG 250 μg (n=185), group B received r-hCG 500 μg (n=461), and group C received GnRHa 0.2 mg and r-hCG 250 μg (n=86). The clinical pregnancy rate (28.1% vs. 36.0% vs. 29.1%) and ongoing pregnancy rate (24.3% vs. 33.4% vs. 22.1%) was the highest in group B, but there was a significant difference compared to group A , but no significant difference from group C. Biochemical pregnancy rates were also the highest in group B with 40.5%, 45.6%, and 37.2%, but there was no significant difference. In addition, although the average number of retrieved oocytes(5.6±3.2 vs. 8.9±3.4 vs.7.8±3.4) and average number of mature oocytes(3.9±2.4 vs. 7.1±2.5 vs.5.2±3.1) were the highest in group B, there was a significant difference compared to group A, but no significant difference compared to group C. The average number of embryos (3.8±2.3 vs. 6.9±2.3 vs.4.4±2.6) was also the highest in group B, but there was no significant difference. Double-dose hCG triggering improves oocyte quality and pregnancy outcomes compared to single-dose hCG triggering and dual trigger with GnRH-Agonist with hCG in advanced-age women undergoing IVF-ICSI cycles.