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高未成熟卵母细胞率预期正常反应者最终卵母细胞成熟的双重触发因素:一项随机对照试验

Dual trigger for final oocyte maturation in expected normal responders with a high immature oocyte rate: a randomized controlled trial.

作者信息

Yan Meng-Han, Sun Zhen-Gao, Song Jing-Yan

机构信息

The First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, China.

Reproductive Center of Integrated Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.

出版信息

Front Med (Lausanne). 2023 Oct 5;10:1254982. doi: 10.3389/fmed.2023.1254982. eCollection 2023.

Abstract

OBJECTIVE

To evaluate whether dual trigger could improve reproductive outcomes in women with low oocyte maturation rates compare to human chorionic gonadotropin (hCG) trigger.

METHODS

This study included expected normal ovarian responders younger than 40 years old whose immature oocyte rate in the previous cycle was more than 50% at the reproductive center from July 2021 to November 2022. A total of 73 patients were enrolled at trigger, including 34 in the hCG trigger group and 39 in the dual trigger group (co-administration of gonadotrophin releasing hormone (GnRH) agonist and hCG, 40 and 34 h prior to oocyte retrieval, respectively). The primary outcome was oocyte maturation rate.

RESULTS

There was no significant difference in the number of oocytes retrieved between the two study groups, but the oocyte maturation rate was higher in dual trigger group (84.0% [14.0%] vs. 55.5% [19.8%],  < 0.001). Moreover, there were also higher cumulative pregnancy rate (69.4% vs. 40.0%,  = 0.035) and cumulative live birth rate (66.7% vs. 36.0%,  = 0.022) in dual trigger group.

CONCLUSION

For normal responders with low oocyte maturation rates, the dual trigger may be more effective than the conventional hCG trigger.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov, identifier ChiCTR2100049292.

摘要

目的

评估与人类绒毛膜促性腺激素(hCG)扳机相比,双重扳机是否能改善卵母细胞成熟率低的女性的生殖结局。

方法

本研究纳入了2021年7月至2022年11月在生殖中心就诊的年龄小于40岁的预期正常卵巢反应者,其前一周期未成熟卵母细胞率超过50%。共73例患者在扳机时入组,其中hCG扳机组34例,双重扳机组39例(分别在取卵前40和34小时联合使用促性腺激素释放激素(GnRH)激动剂和hCG)。主要结局是卵母细胞成熟率。

结果

两个研究组之间的取卵数无显著差异,但双重扳机组的卵母细胞成熟率更高(84.0% [14.0%] 对55.5% [19.8%],<0.001)。此外,双重扳机组的累积妊娠率(69.4%对40.0%,=0.035)和累积活产率(66.7%对36.0%,=0.022)也更高。

结论

对于卵母细胞成熟率低的正常反应者,双重扳机可能比传统的hCG扳机更有效。

临床试验注册

ClinicalTrials.gov,标识符ChiCTR2100049292。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddcd/10585044/e811c9f14b6e/fmed-10-1254982-g001.jpg

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