Effect of GnRH agonist trigger with or without low-dose hCG on reproductive outcomes for PCOS women with freeze-all strategy: a propensity score matching study

Purpose This study aimed to compare the effect of gonadotropin-releasing hormone agonist (GnRHa) trigger alone versus dual trigger comprising GnRHa and low-dose human chorionic gonadotropin (hCG) on reproductive outcomes in patients with polycystic ovary syndrome (PCOS) who received the freeze-all s...

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Bibliographic Details
Published in:Archives of gynecology and obstetrics 2024-02, Vol.309 (2), p.679-688
Main Authors: Wang, Qiaofeng, Wan, Qi, Li, Tian, Wang, Xuejiao, Hu, Yuling, Zhong, Zhaohui, Pu, Kexue, Ding, Yubin, Tang, Xiaojun
Format: Article
Language:English
Subjects:
Chorionic Gonadotropin - pharmacology
Drug dosages
Endocrinology
Female
Fertilization in Vitro - methods
Gonadotropin-Releasing Hormone - pharmacology
Gynecologic Endocrinology and Reproductive Medicine
Gynecology
Human Genetics
Humans
Infant, Newborn
Medicine
Medicine & Public Health
Obstetrics/Perinatology/Midwifery
Oocytes
Ovarian Hyperstimulation Syndrome - epidemiology
Ovarian Hyperstimulation Syndrome - prevention & control
Ovulation Induction - methods
Polycystic ovary syndrome
Polycystic Ovary Syndrome - complications
Polycystic Ovary Syndrome - drug therapy
Pregnancy
Pregnancy Rate
Propensity Score
Regression analysis
Retrospective Studies
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Summary:Purpose This study aimed to compare the effect of gonadotropin-releasing hormone agonist (GnRHa) trigger alone versus dual trigger comprising GnRHa and low-dose human chorionic gonadotropin (hCG) on reproductive outcomes in patients with polycystic ovary syndrome (PCOS) who received the freeze-all strategy. Methods A total of 615 cycles were included in this retrospective cohort study. Propensity score matching (PSM) was performed to control potential confounding factors between GnRHa-trigger group (0.2 mg GnRHa) and dual-trigger group (0.2 mg GnRHa plus 1000/2000 IU hCG) in a 1:1 ratio. Multivariate logistic regression was applied to estimate the association between trigger methods and reproductive outcomes. Results After PSM, patients with dual trigger ( n  = 176) had more oocytes retrieved, mature oocytes, and 2PN embryos compared to that with GnRHa trigger alone. However, the oocytes maturation rate, normal fertilization rate, and frozen embryos between the two groups were not statistically different. The incidence of ovarian hyperstimulation syndrome (OHSS) (14.8% vs. 2.8%, P  
ISSN:1432-0711
0932-0067
1432-0711
DOI:10.1007/s00404-023-07285-1