Volume 21, Issue 5 (May 2023)                   IJRM 2023, 21(5): 395-402 | Back to browse issues page

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Yildirim Kopuk S, Utkan Korun Z E, Yuceturk A, Karaosmanoglu O, Yazicioglu C, Tiras B et al . Does dual trigger improve euploidy rate in normoresponder? A cross-sectional study. IJRM 2023; 21 (5) :395-402
URL: http://ijrm.ir/article-1-2600-en.html
Does dual trigger improve euploidy rate in normoresponder? A cross-sectional study
Sule Yildirim Kopuk * 1, Zeynep Ece Utkan Korun2 , Aysen Yuceturk2 , Ozge Karaosmanoglu2 , Caglar Yazicioglu2 , Bulent Tiras3 , Yigit Cakiroglu3
1- Acibadem Maslak Hospital, Assisted Reproductive Technologies Unit, Istanbul, Turkey. , suleyildirim@msn.com
2- Acibadem Maslak Hospital, Assisted Reproductive Technologies Unit, Istanbul, Turkey.
3- Acibadem Maslak Hospital, Assisted Reproductive Technologies Unit, Istanbul, Turkey. Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.
Abstract:   (494 Views)
Background: With the introduction of the dual triggering-gonadotropin-releasing hormone (GnRH) analog and recombinant human chorionic gonadotropin (hCG) combination, women with a history of low mature oocyte proportion and empty follicle syndrome were shown to benefit from the dual trigger.
Objective: To investigate whether dual triggering of oocyte maturation with a GnRH agonist (GnRHa) combined with hCG can affect the euploidy rate and improve in vitro fertilization outcomes for normoresponder women.
Materials and Methods: In this cross-sectional study, 494 women who underwent controlled ovarian stimulation with hCG (n = 274) or dual triggering (hCG+GnRHa, n = 220) at Acibadem Maslak hospital, Assisted Reproductive Unit, from January 2019-2022 were enrolled in this study. Preimplantation genetic testing for aneuploidy was performed on all participants.
Results: Both groups had similar baseline and clinical characteristics. Of the 881 embryos biopsied, 312 (35.4%) were reported as euploid in the hCG trigger group; in the dual trigger group, 186 (29.8%) of 623 screening embryos were reported as euploid. The hCG group had a higher euploidy rate per biopsied embryo, although the difference was not statistically significant (31.4 ± 26.5 vs. 26.5 ± 33.3, p > 0.05).
Conclusion: In normoresponders, adding GnRHa for final follicular maturation to hCG did not improve the euploidy rate.
Keywords: Gonadotropin-releasing hormone, Chorionic gonadotropin, Preimplantation screening, Aneuploidy.
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Type of Study: Original Article | Subject: Reproductive Endocrinology
References
1. Fritz MA, Speroff L. Clinical gynecologic endocrinology and infertility. 9th Ed. Philadelphia: Lippincott Williams & Wilkins; 2020.
2. Abbara A, Hunjan T, Ho VNH, Clarke SA, Comninos AN, Izzi-Chioma C, et al. Endocrine requirements for oocyte maturation following hCG, GnRH agonist, and kisspeptin during IVF treatment. Front Endocrinol (Lausanne) 2020; 11: 537205. [DOI:10.3389/fendo.2020.537205] [PMID] [PMCID]
3. Castillo JC, Humaidan P, Bernabéu R. Pharmaceutical options for triggering of final oocyte maturation in ART. BioMed Res Int 2014; 2014: 580171. [DOI:10.1155/2014/580171] [PMID] [PMCID]
4. Abbara A, Clarke SA, Dhillo WS. Novel concepts for inducing final oocyte maturation in in vitro fertilization treatment. Endocr Rev 2018; 39: 593-628. [DOI:10.1210/er.2017-00236] [PMID] [PMCID]
5. Gonen Y, Balakıer H, Powell W, Casper RF. Use of gonadotropin-releasing hormone agonist to trigger follicular maturation for in vitro fertilization. J Clin Endocrinol Metab 1990; 71: 918-922. [DOI:10.1210/jcem-71-4-918] [PMID]
6. Ben-Ami I, Komsky A, Bern O, Kasterstein E, Komarovsky D, Ron-El R. In vitro maturation of human germinal vesicle-stage oocytes: Role of epidermal growth factor-like growth factors in the culture medium. Hum Reprod 2011; 26: 76-81. [DOI:10.1093/humrep/deq290] [PMID]
7. Humaidan P, Westergaard LG, Mikkelsen AL, Fukuda M, Andersen CY. Levels of the epidermal growth factor-like peptide amphiregulin in follicular fluid reflect the mode of triggering ovulation: A comparison between gonadotrophin-releasing hormone agonist and urinary human chorionic gonadotrophin. Fertil Steril 2011; 95: 2034-2038. [DOI:10.1016/j.fertnstert.2011.02.013] [PMID]
8. Shapiro BS, Daneshmand ST, Garner FC, Aguirre M, Thomas S. Gonadotropin-releasing hormone agonist combined with a reduced dose of human chorionic gonadotropin for final oocyte maturation in fresh autologous cycles of in vitro fertilization. Fertil Steril 2008; 90: 231-233. [DOI:10.1016/j.fertnstert.2007.06.030] [PMID]
9. Griffin D, Feinn R, Engmann L, Nulsen J, Budinetz T, Benadiva C. Dual trigger with gonadotropin-releasing hormone agonist and standard dose human chorionic gonadotropin to improve oocyte maturity rates. Fertil Steril 2014; 102: 405-409. [DOI:10.1016/j.fertnstert.2014.04.028] [PMID]
10. Beck-Fruchter R, Weiss A, Lavee M, Geslevich Y, Shalev E. Empty follicle syndrome: Successful treatment in a recurrent case and review of the literature. Hum Reprod 2012; 27: 1357-1367. [DOI:10.1093/humrep/des037] [PMID]
11. Cao X-L, Sun Z-G. Borderline form of empty follicle syndrome treated with a novel dual trigger method combined with delayed oocyte retrieval: A case report. World J Clin Cases 2020; 8: 825-830. [DOI:10.12998/wjcc.v8.i4.825] [PMID] [PMCID]
12. Lin M-H, Wu FS-Y, Lee RK-K, Li S-H, Lin S-Y, Hwu Y-M. 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. Fertil Steril 2013; 100: 1296-1302. [DOI:10.1016/j.fertnstert.2013.07.1976] [PMID]
13. Zilberberg E, Haas J, Dar S, Kedem A, Machtinger R, Orvieto R. Co-administration of GnRH-agonist and hCG, for final oocyte maturation (double trigger), in patients with low proportion of mature oocytes. Gynecol Endocrinol 2015; 31: 145-147. [DOI:10.3109/09513590.2014.978850] [PMID]
14. Hong YH, Kim SK, Lee JR, Jee BC, Suh CS. Clinical efficacy of dual trigger with human chorionic gonadotropin and a gonadotropin-releasing hormone agonist for women undergoing fertility preservation. Reprod Med Biol 2022; 21: e12440. [DOI:10.1002/rmb2.12440] [PMID] [PMCID]
15. Haas J, Ophir L, Barzilay E, Machtinger R, Yung Y, Orvieto R, et al. Standard human chorionic gonadotropin versus double trigger for final oocyte maturation results in different granulosa cells gene expressions: A pilot study. Fertil Steril 2016; 106: 653-659. [DOI:10.1016/j.fertnstert.2016.06.002] [PMID]
16. Thorne J, Loza A, Kaye L, Nulsen J, Benadiva C, Grow D, et al. Euploidy rates between cycles triggered with gonadotropin-releasing hormone agonist and human chorionic gonadotropin. Fertil Steril 2019; 112: 258-265. [DOI:10.1016/j.fertnstert.2019.03.040] [PMID]
17. Tan J, Jing C, Zhang L, Lo J, Kan A, Nakhuda G. GnRH triggering may improve euploidy and live birth rate in hyper-responders: A retrospective cohort study. J Assist Reprod Genet 2020; 37: 1939-1948. [DOI:10.1007/s10815-020-01842-2] [PMID] [PMCID]
18. Bourdon M, Peigne M, Solignac C, Darne B, Languille S, Pocate-Cheriet K, et al. Gonadotropin-releasing hormone agonist (alone or combined with human chorionic gonadotropin) vs. human chorionic gonadotropin alone for ovulation triggering during controlled ovarian stimulation for in vitro fertilization/intracytoplasmic sperm injection: A systematic review and meta-analysis. F&S Reviews 2021; 2: 353-370. [DOI:10.1016/j.xfnr.2021.08.003]
19. Ding N, Liu X, Jian Q, Liang Z, Wang F. Dual trigger of final oocyte maturation with a combination of GnRH agonist and hCG versus a hCG alone trigger in GnRH antagonist cycle for in vitro fertilization: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2017; 218: 92-98. [DOI:10.1016/j.ejogrb.2017.09.004] [PMID]
20. Weissman A, Howles CM, Shoham Z. Textbook of assisted reproductive technologies. Boca Raton: CRC Press and Taylor & Francis Group. 2018.
21. Youssef MAFM, Van der Veen F, Al-Inany HG, Mochtar MH, Griesinger G, Mohesen MN, et al. Gonadotropin-releasing hormone agonist versus HCG for oocyte triggering in antagonist-assisted reproductive technology. Cochrane Database Syst Rev 2014; 10: CD008046. [DOI:10.1002/14651858.CD008046.pub4] [PMID]
22. Cimadomo D, Vaiarelli A, Petriglia C, Fabozzi G, Ferrero S, Schimberni M, et al. Oocyte competence is independent of the ovulation trigger adopted: A large observational study in a setting that entails vitrified-warmed single euploid blastocyst transfer. J Assist Reprod Genet 2021; 38: 1419-1427. [DOI:10.1007/s10815-021-02124-1] [PMID] [PMCID]
23. Herzberger EH, Knaneh S, Amir H, Reches A, Ben-Yosef D, Kalma Y, et al. Gonadotropin-releasing hormone agonist versus recombinant human chorionic gonadotropin triggering in fertility preservation cycles. Reprod Sci 2021; 28: 3390-3396. [DOI:10.1007/s43032-021-00622-2] [PMID]
24. Orvieto R. Triggering final follicular maturation-hCG, GnRH-agonist or both, when and to whom? J Ovarian Res 2015; 8: 60. [DOI:10.1186/s13048-015-0187-6] [PMID] [PMCID]
25. Tannus S, Turki R, Cohen Y, Son W-Y, Shavit T, Dahan MH. Reproductive outcomes after a single dose of gonadotropin-releasing hormone agonist compared with human chorionic gonadotropin for the induction of final oocyte maturation in hyper-responder women aged 35-40 years. Fertil Steril 2017; 107: 1323-1328. [DOI:10.1016/j.fertnstert.2017.04.014] [PMID]
26. Haas J, Zilberberg E, Dar S, Kedem A, Machtinger R, Orvieto R. Co-administration of GnRH-agonist and hCG for final oocyte maturation (double trigger) in patients with low number of oocytes retrieved per number of preovulatory follicles-a preliminary report. J Ovarian Res 2014; 7: 77. [DOI:10.1186/1757-2215-7-77] [PMID] [PMCID]
27. Haas J, Zilberberg E, Nahum R, Sason AM, Hourvitz A, Gat I, et al. Does double trigger (GnRH-agonist + hCG) improve outcome in poor responders undergoing IVF-ET cycle? A pilot study. Gynecol Endocrinol 2019; 35: 628-630. [DOI:10.1080/09513590.2019.1576621] [PMID]
28. Haas J, Bassil R, Samara N, Zilberberg E, Mehta C, Orvieto R, et al. GnRH agonist and hCG (dual trigger) versus hCG trigger for final follicular maturation: A double-blinded, randomized controlled study. Hum Reprod 2020; 35: 1648-1654. [DOI:10.1093/humrep/deaa107] [PMID]
29. Decleer W, Osmanagaoglu K, Seynhave B, Kolibianakis S, Tarlatzis B, Devroey P. Comparison of hCG triggering versus hCG in combination with a GnRH agonist: A prospective randomized controlled trial. Facts Views Vis Obgyn 2014; 6: 203-209.
30. Mohr-Sasson A, Orvieto R, Blumenfeld S, Axelrod M, Mor-Hadar D, Grin L, et al. The association between follicle size and oocyte development as a function of final follicular maturation triggering. Reprod Biomed Online 2020; 40: 887-893. [DOI:10.1016/j.rbmo.2020.02.005] [PMID]
31. Cascales A, Lledó B, Ortiz JA, Morales R, Ten J, Llácer J, et al. Effect of ovarian stimulation on embryo aneuploidy and mosaicism rate. Syst Biol Reprod Med 2021; 67: 42-49. [DOI:10.1080/19396368.2020.1850908] [PMID]
32. Demirel C, Celik HG, Tulek F, Uzun K, Bastu E. Dual trigger with hCG Plus GnRHa for final oocyte maturation in PGT-A cycles results in similar euploidy rates when compared to hCG-only trigger. Reprod Sci 2022; 29: 2265-2271. [DOI:10.1007/s43032-022-00954-7] [PMID]
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