Núcleo Santista de Reprodução Humana, Santos - SP, Brazil.
Urology Department, Medical School, Faculdade Ingá, Maringá, Brazil.
JBRA Assist Reprod. 2021 Apr 27;25(2):246-251. doi: 10.5935/1518-0557.20200089.
To analyze gonadotropin-releasing hormone (GnRH) agonist in association with human chorionic gonadotropin (hCG) (dual triggering) versus hCG alone (conventional triggering) for final oocyte maturation triggering in GnRH antagonist cycles in an unselected population of Brazilian women.
This prospective case-control study involved 114 patients referred to autologous in vitro fertilization treatment between February 2018 and August 2019, recruited regardless of age, infertility factor or number of cycles. The patients were randomly allocated into two groups according to oocyte maturation triggering approach: group A (n = 48) - hCG only; and group B (n = 66) - hCG plus GnRH agonist. The main outcomes measured were the number of total and metaphase II (MII) oocytes retrieved.
The groups were homogenous in terms of age. There were no moderate or severe ovarian hyperstimulation syndrome events. There were no statistical differences concerning total or MII oocytes retrieved between the groups (p > 0.05). The MII/total oocyte rate was 70.9% in group A, and 74.5% in group B (p = 0.679). There was no oocyte retrieved in 2/48 patients (4.16%) in group A, 1/66 (1.5%) in group B. There were no MII oocytes in 4/48 patients (8.3%) in group A, and 2/66 (3%) in group B. Age was directly correlated to the number of total and MII oocytes retrieved (p < 0.05).
Dual triggering was equivalent to conventional hCH triggering in terms of the number of total and MII oocytes retrieved in the general population. Further studies are necessary to ascertain dual triggering indication in selected groups of women.
分析促性腺激素释放激素(GnRH)激动剂联合人绒毛膜促性腺激素(hCG)(双重触发)与单独使用 hCG(常规触发)在 GnRH 拮抗剂周期中对未选择的巴西女性人群中卵母细胞最终成熟的触发效果。
这是一项前瞻性病例对照研究,纳入了 2018 年 2 月至 2019 年 8 月间进行自体体外受精治疗的 114 名患者,无论年龄、不孕因素或周期数如何,均被纳入研究。患者根据卵母细胞成熟触发方式随机分配到两组:A 组(n = 48)-仅使用 hCG;B 组(n = 66)-hCG 加 GnRH 激动剂。主要结局测量指标为总卵母细胞和减数分裂 II 期(MII)卵母细胞的数量。
两组在年龄方面具有同质性。无中重度卵巢过度刺激综合征事件发生。两组间总卵母细胞或 MII 卵母细胞的数量无统计学差异(p > 0.05)。A 组的 MII/total 卵母细胞率为 70.9%,B 组为 74.5%(p = 0.679)。A 组有 2/48 例(4.16%)患者无卵母细胞取出,B 组有 1/66 例(1.5%)患者无卵母细胞取出。A 组有 4/48 例(8.3%)患者无 MII 卵母细胞,B 组有 2/66 例(3%)患者无 MII 卵母细胞。年龄与总卵母细胞和 MII 卵母细胞的数量呈直接相关(p < 0.05)。
在一般人群中,双重触发在总卵母细胞和 MII 卵母细胞的数量方面与常规 hCG 触发相当。需要进一步的研究来确定在特定女性人群中双重触发的适应证。