Reproductive Center, The First Affiliated Hospital of Shantou University Medical College, Shantou University, Shantou, Guangdong, P.R. China.
Medicine (Baltimore). 2023 Feb 3;102(5):e32867. doi: 10.1097/MD.0000000000032867.
The dual-trigger regime, consisting of gonadotrophin releasing hormone agonist and human chorionic gonadotropin (HCG), has been shown to offer advantage over the HCG-only trigger regime. However, little is known about the influence of dual-trigger or HCG-only trigger regime on the reproductive outcome of polycystic ovary syndrome (PCOS) couples undergoing controlled ovarian stimulation (COS) and intrauterine insemination (IUI). A total of 404 cycles of COS and IUI treatments from couples with PCOS were enrolled, and divided, according to the regime of trigger, into dual-trigger group (n = 109, 0.1-0.2 mg gonadotrophin releasing hormone agonist plus 6000 IU HCG) and HCG-only group (n = 295, 10,000 IU HCG or 250 μg recombinant HCG). Baseline characteristics of the 2 groups were comparable (all P > .05). In dual-trigger group, live birth rate, clinical pregnancy rate and β -HCG positive rate were all higher as compared to the HCG-only group (20.18% vs 18.98%, 25.69% vs 23.39% and 28.44% vs 25.08% respectively), despite the differences failed to achieve statistical significances (all P > .05). Moreover, early miscarriage rate and multiple pregnancy rate of the dual-trigger group were lower than those of the HCG-only group (17.86% vs 18.84% and 3.57% vs 7.25% respectively), although no statistical significances were found (all P > .05). Additionally, logistic regression analysis revealed that age contributed significantly to the live birth of couples with PCOS ( P = .043, OR = 0.900). Dual-trigger regime for oocyte maturation seems to associate with beneficial improvements in reproductive outcomes of PCOS couples undergoing COS and IUI. Instead of HCG-only trigger, dual-trigger regime might be an alternative option in COS and IUI cycles for couples with PCOS.
双重触发方案，包括促性腺激素释放激素激动剂和人绒毛膜促性腺激素（HCG），已被证明优于仅用 HCG 触发的方案。然而，对于接受控制性卵巢刺激（COS）和宫腔内人工授精（IUI）的多囊卵巢综合征（PCOS）夫妇，双重触发或仅用 HCG 触发方案对其生殖结局的影响知之甚少。共有 404 个 PCOS 夫妇的 COS 和 IUI 治疗周期被纳入研究，并根据触发方案分为双重触发组（n = 109，0.1-0.2mg 促性腺激素释放激素激动剂加 6000IU HCG）和 HCG 仅触发组（n = 295，10000IU HCG 或 250μg 重组 HCG）。两组的基线特征相当（均 P＞.05）。在双重触发组中，活产率、临床妊娠率和β-HCG 阳性率均高于 HCG 仅触发组（分别为 20.18%比 18.98%、25.69%比 23.39%和 28.44%比 25.08%），尽管差异无统计学意义（均 P＞.05）。此外，双重触发组的早期流产率和多胎妊娠率低于 HCG 仅触发组（分别为 17.86%比 18.84%和 3.57%比 7.25%），尽管差异无统计学意义（均 P＞.05）。此外，逻辑回归分析显示，年龄对 PCOS 夫妇的活产有显著影响（P=.043，OR=0.900）。卵母细胞成熟的双重触发方案似乎与接受 COS 和 IUI 的 PCOS 夫妇的生殖结局的有益改善相关。对于 PCOS 夫妇的 COS 和 IUI 周期，双重触发方案可能优于仅用 HCG 触发方案。
