AUTHOR=Zhu Haiyan , Zhao Chenqiong , Pan Yibin , Zhou Hanjing , Jin Xiaoying , Xu Wen , Zhang Songying 

TITLE=Dual Trigger for Final Follicular Maturation Improves Cumulative Live-Birth Rate in Ovarian Stimulation for Freeze-All In Vitro Fertilization/Intracytoplasmic Sperm Injection Cycles

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2021.708247

DOI=10.3389/fendo.2021.708247

ISSN=1664-2392

ABSTRACT=Research Question:  Does dual trigger in freeze-all  in vitro  fertilization
(IVF)/intracytoplasmic sperm injection (ICSI) cycles improve the cumulative live-birth
outcome compared with human chorionic gonadotropin (hCG) trigger?
Design:  A 6-years population-based retrospective cohort analysis using individual
patient data. A total of 4438 women were analyzed from their single ovarian stimulation
cycle until they had a live birth or had used all their embryos.

Result(s):  A total of 4438 IVF/ICSI cycles were analyzed, including 1445 cycles with
single hCG trigger and 2993 cycles with dual trigger. The cumulative biochemical
pregnancy rate (60.8% vs. 68.1%, P<0.001; odds ratio (OR): 0.727; 95% confidence
interval (CI): 0.638–0.828), cumulative clinical pregnancy rate (52.9% vs. 58.5%,
P<0.001; OR: 0.796; 95%CI: 0.701–0.903), and CLBR (44.3% vs. 50.5%, P<0.001;
OR: 0.781; 95%CI: 0.688–10.886) were all significantly lower in the hCG-trigger group
compared with the dual-trigger group. The clinical pregnancy rate (48.2% vs. 58.2%,
P=0.002; OR: 0.829; 95%CI: 0.737–0.934), embryo implantation rate (34.4% vs.
38.9%, P<0.001; OR: 0.823; 95%CI: 0.750–0.903), and live-birth rate (26.6% vs.
31.7%, P<0.001; OR: 0.783; 95%CI: 0.709–0.864) were also significantly lower in the
hCG-trigger group compared with the dual-trigger group. After controlling for all
potential confounding variables, the trigger method was identified as an independent
factor affecting the CLBR. The OR and 95%CI for hCG trigger were 0.839 and
0.711–0.990 (P=0.037).

Conclusion(s):  Dual trigger for final follicular maturation improves the cumulative
pregnancy and live-birth rates compared with hCG trigger in freeze-all IVF/ICSI cycles.