雙重破卵(HCG+GnRHagonist)可提高懷孕率

COH+GnRHantagonist誘導排卵最後除打破卵針HCG外另外施打GnRHagonist 0.2mg (0.04cc)可能可提高胚胎著床率與懷孕率

http://www.ncbi.nlm.nih.gov/pubmed/23993928

Fertil Steril. 2013 Aug 28. pii: S0015-0282(13)02762-3. doi: 10.1016/j.fertnstert.2013.07.1976. [Epub ahead of print]

Dual trigger with combination of gonadotropin-releasing hormone agonist and human chorionic gonadotropin significantly improves the live-birth rate for normal responders in GnRH-antagonist cycles.

Lin MH, Shao-Ying Wu F, Kuo-Kuang Lee R, Li SH, Lin SY, Hwu YM.

Source

Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing, and Management College, Taipei, Taiwan.

Abstract

OBJECTIVE:

To investigate whether dual triggering of final oocyte maturation with a combination of gonadotropin-releasing hormone (GnRH) agonist and human chorionic gonadotropin (hCG) can improve the live-birth rate for normal responders in GnRH-antagonist in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI) cycles.

DESIGN:

Retrospective cohort study.

SETTING:

Infertility unit of a university-affiliated medical center.

PATIENT(S):

Normal responders to controlled ovarian hyperstimulation who were undergoing IVF-ICSI with a GnRH antagonist protocol.

INTERVENTION(S):

Standard dosage of hCG trigger (6,500 IU of recombinant hCG) versus dual trigger (0.2 mg of triptorelin and 6,500 IU of recombinant hCG).

MAIN OUTCOME MEASURE(S):

Live-birth, clinical pregnancy, and implantation rates per cycle.

RESULT(S):

A total of 376 patients with 378 completed cycles with embryo transfer were enrolled (hCG trigger/control group: n = 187; dual trigger/study group: n = 191). The dual trigger group demonstrated statistically significantly higher implantation (29.6% vs. 18.4%), clinical pregnancy (50.7% vs. 40.1%), and live-birth (41.3% vs. 30.4%) rates as compared with the hCG trigger group. There was no statistically significant difference in terms of patient demographics, cycle parameters, or embryo quality.

CONCLUSION(S):

Dual trigger of final oocyte maturation with a GnRH-agonist and a standard dosage of hCG in normal responders statistically significantly improves implantation, clinical pregnancy, and live-birth rates in GnRH-antagonist IVF cycles.