Dados do Trabalho

Title

OOCYTE MATURATION RATE AFTER DOUBLE TRIGGER

Objective

Coadministration of GnRH agonist and human chorionic gonadotropin (hCG) in IVF cycles is associated with a higher number of oocytes, mature oocytes and number of blastocysts compared to triggering with hCG alone. hCG is used in order to simulate an LH surge at the end of controlled ovarian hyperstimulation to induce final oocyte maturation. The combination of GnRH agonist and low dose hCG, called "double trigger", has been suggested by previous studies as a method to improve IVF outcome and pregnancy rates. (HAAS, J. et al., 2020). The aim of this study is to evaluate oocyte maturity at metaphase II (MII) rate with the use of Double Trigger versus Single Trigger.

Methods

The respective study, performed at Androlab, an Assisted Reproduction Technology (ART) Center located in Curitiba, Brazil, between january/2021 and july/2023. All cycles of Intracytoplasmic Sperm Injection (ICSI) performed at this center were included. Patients were separated into five groups, two of which underwent the double trigger procedure, while the other three underwent the single trigger.

Results

The investigation evaluated a total of 749 patients, of whom 254 underwent the double trigger procedure with a combination of Gonapeptyl (GnRH agonist) and Choriomon (hCG) or Gonapeptyl and Ovidrel (hCG); and the other 495 underwent the single trigger with administration of Gonapeptyl, Ovidrel or Choriomon alone. 2328 of the 3378 recovered oocytes from patients receiving Choriomon alone were MII oocytes, resulting in a maturity rate of 69%. In patients who received Ovidrel alone, 35 of the 51 recovered oocytes were MII oocytes, also resulting in a maturity rate of 69%. 1341 of the 1851 recovered oocytes from patients receiving Gonapeptyl alone were MII oocytes, amounting to a maturity rate of 72%. Whereas in the case of double triggers, 77 of the 99 recovered oocytes from patients who received the association of Gonapeptyl and Ovidrel reached MII, resulting in a maturity rate of 78%. In patients who received the association of Gonapeptyl and Choriomon, 1892 of the 2528 recovered oocytes were MII, which constitutes a maturity rate of 75%. Without distinguishing between the drugs used, the study found that 3704 of the 5280 recovered oocytes from patients receiving a single trigger were MII, resulting in a 70% maturity rate, while 1969 of the 2627 recovered oocytes from patients receiving a double trigger reached MII, accounting for a 75% maturity rate.

Conclusion

The use of the double trigger showed better oocyte maturity rate results compared to the single trigger. Limitations of the present study include the difference in the amount of follicles of the two groups (single trigger and double trigger), data from a single institution and retrospective design.

Keywords

double trigger, oocyte maturation, single trigger, maturation rate.