The Effect of Dual Trigger on In Vitro Fertilization/Intracytoplasmic Sperm Injection Outcomes in Patients with Suboptimal Ovarian Response (POSEIDON Classification Group I): A Randomized Clinical Trial
Background: The study was conducted to investigate the effect of dual trigger with gonadotropin-releasing hormone agonist (GnRH-a) and standard dose human chorionic gonadotropin (hCG) on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes in patients with a history of subopti...
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Royan Institute (ACECR), Tehran
2025-07-01
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| Series: | International Journal of Fertility and Sterility |
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| Online Access: | https://www.ijfs.ir/article_719679_7eb915368493ce5daf8f4f98eaf0d6e6.pdf |
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| author | Maryam Hafezi Arezoo Arabipoor Maryam Zareei Samira Vesali Parisa Mostafaei Nadia Zameni |
| author_facet | Maryam Hafezi Arezoo Arabipoor Maryam Zareei Samira Vesali Parisa Mostafaei Nadia Zameni |
| author_sort | Maryam Hafezi |
| collection | DOAJ |
| description | Background: The study was conducted to investigate the effect of dual trigger with gonadotropin-releasing hormone agonist (GnRH-a) and standard dose human chorionic gonadotropin (hCG) on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes in patients with a history of suboptimal ovarian response.Materials and Methods: In this randomized clinical trial, 52 infertile women who were referred to Royan Institute from November 2019 to November 2022 for a second treatment with IVF/ICSI cycles, and had a suboptimal ovarian response [the Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number (POSEIDON) classification group I] in their previous cycle were evaluated. Ovulation stimulation was performed in all patients with the standard antagonist protocol. At the point of the final ovarian stimulation, patients were randomly assigned into two groups using the permuted block randomization method. In the dual trigger group, 0.2 mg of GnRH-a and two ampoules of recombinant hCG subcutaneously were administered to the patients at the same time. In control group, only two ampoules of recombinant hCG were injected subcutaneously. The ovarian stimulation outcomes and pregnancy rates were compared between groups utilizing appropriate statistical methods.Results: The two groups were homogeneous in terms of baseline characteristics. The statistical differences were found between groups in terms of, the total number of retrieved oocytes and the number of metaphase II (MII) oocytes as well as the number of obtained and frozen embryos in the dual trigger group were significantly more than those of in the control group (P=0.001, P=0.022, P=0.01, and P=0.035, respectively). The clinical pregnancy and live birth rates in the dual group were higher than those of the control group; nevertheless, the differences were not statistically significant (40.9 vs. 25% and 40.9 vs. 20%, P=0.275 and P=0.143, respectively).Conclusion: By virtue of these findings, dual trigger significantly improved the ovarian stimulation outcomes in the patients with a history of unexpected poor response. To validate the current findings, further clinical trials with larger sample sizes are required (registration number: NCT04549649). |
| format | Article |
| id | doaj-art-a5cf0b7d5d58429784e16b0db7630f62 |
| institution | OA Journals |
| issn | 2008-076X 2008-0778 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Royan Institute (ACECR), Tehran |
| record_format | Article |
| series | International Journal of Fertility and Sterility |
| spelling | doaj-art-a5cf0b7d5d58429784e16b0db7630f622025-08-20T02:37:41ZengRoyan Institute (ACECR), TehranInternational Journal of Fertility and Sterility2008-076X2008-07782025-07-0119325125810.22074/ijfs.2025.2027114.1669719679The Effect of Dual Trigger on In Vitro Fertilization/Intracytoplasmic Sperm Injection Outcomes in Patients with Suboptimal Ovarian Response (POSEIDON Classification Group I): A Randomized Clinical TrialMaryam Hafezi0Arezoo Arabipoor1Maryam Zareei2Samira Vesali3Parisa Mostafaei4Nadia Zameni5Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, IranDepartment of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, IranDepartment of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, IranDepartment of Basic and Population Based Studies in NCD, Reproductive Epidemiology Research Center, Royan Institute, ACECR, Tehran, IranDepartment of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, IranSchool of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranBackground: The study was conducted to investigate the effect of dual trigger with gonadotropin-releasing hormone agonist (GnRH-a) and standard dose human chorionic gonadotropin (hCG) on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes in patients with a history of suboptimal ovarian response.Materials and Methods: In this randomized clinical trial, 52 infertile women who were referred to Royan Institute from November 2019 to November 2022 for a second treatment with IVF/ICSI cycles, and had a suboptimal ovarian response [the Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number (POSEIDON) classification group I] in their previous cycle were evaluated. Ovulation stimulation was performed in all patients with the standard antagonist protocol. At the point of the final ovarian stimulation, patients were randomly assigned into two groups using the permuted block randomization method. In the dual trigger group, 0.2 mg of GnRH-a and two ampoules of recombinant hCG subcutaneously were administered to the patients at the same time. In control group, only two ampoules of recombinant hCG were injected subcutaneously. The ovarian stimulation outcomes and pregnancy rates were compared between groups utilizing appropriate statistical methods.Results: The two groups were homogeneous in terms of baseline characteristics. The statistical differences were found between groups in terms of, the total number of retrieved oocytes and the number of metaphase II (MII) oocytes as well as the number of obtained and frozen embryos in the dual trigger group were significantly more than those of in the control group (P=0.001, P=0.022, P=0.01, and P=0.035, respectively). The clinical pregnancy and live birth rates in the dual group were higher than those of the control group; nevertheless, the differences were not statistically significant (40.9 vs. 25% and 40.9 vs. 20%, P=0.275 and P=0.143, respectively).Conclusion: By virtue of these findings, dual trigger significantly improved the ovarian stimulation outcomes in the patients with a history of unexpected poor response. To validate the current findings, further clinical trials with larger sample sizes are required (registration number: NCT04549649).https://www.ijfs.ir/article_719679_7eb915368493ce5daf8f4f98eaf0d6e6.pdfreproductive techniquesoocytesgonadotropin-releasing hormoneovulation inductionrandomized controlled trials |
| spellingShingle | Maryam Hafezi Arezoo Arabipoor Maryam Zareei Samira Vesali Parisa Mostafaei Nadia Zameni The Effect of Dual Trigger on In Vitro Fertilization/Intracytoplasmic Sperm Injection Outcomes in Patients with Suboptimal Ovarian Response (POSEIDON Classification Group I): A Randomized Clinical Trial International Journal of Fertility and Sterility reproductive techniques oocytes gonadotropin-releasing hormone ovulation induction randomized controlled trials |
| title | The Effect of Dual Trigger on In Vitro Fertilization/Intracytoplasmic Sperm Injection Outcomes in Patients with Suboptimal Ovarian Response (POSEIDON Classification Group I): A Randomized Clinical Trial |
| title_full | The Effect of Dual Trigger on In Vitro Fertilization/Intracytoplasmic Sperm Injection Outcomes in Patients with Suboptimal Ovarian Response (POSEIDON Classification Group I): A Randomized Clinical Trial |
| title_fullStr | The Effect of Dual Trigger on In Vitro Fertilization/Intracytoplasmic Sperm Injection Outcomes in Patients with Suboptimal Ovarian Response (POSEIDON Classification Group I): A Randomized Clinical Trial |
| title_full_unstemmed | The Effect of Dual Trigger on In Vitro Fertilization/Intracytoplasmic Sperm Injection Outcomes in Patients with Suboptimal Ovarian Response (POSEIDON Classification Group I): A Randomized Clinical Trial |
| title_short | The Effect of Dual Trigger on In Vitro Fertilization/Intracytoplasmic Sperm Injection Outcomes in Patients with Suboptimal Ovarian Response (POSEIDON Classification Group I): A Randomized Clinical Trial |
| title_sort | effect of dual trigger on in vitro fertilization intracytoplasmic sperm injection outcomes in patients with suboptimal ovarian response poseidon classification group i a randomized clinical trial |
| topic | reproductive techniques oocytes gonadotropin-releasing hormone ovulation induction randomized controlled trials |
| url | https://www.ijfs.ir/article_719679_7eb915368493ce5daf8f4f98eaf0d6e6.pdf |
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