Comparative Study Between Single Versus Dual Trigger for Poor Responders in GnRH-antagonist ICSI Cycles
Status:
Completed
Trial end date:
2019-07-01
Target enrollment:
Participant gender:
Summary
All participants started with a combination of recombinant FSH 300 U and urinary Gn 150 U
from the 2nd day of the cycle then the dose was adjusted according to the ovarian response
From day 6 of the cycle, follow up using transvaginal ultrasound was done either daily or on
alternate days according to the ovarian response. When the leading follicle reached 12 mm,
GnRH antagonist was started using Cetrotide 0.25 subcutaneously daily till the day of
triggering. Triggering was done when at least 3 follicles larger than 14 mm and at least one
of them reached a mean diameter of 17 mm or more.
At the day of triggering, women were randomized into 2 groups. Group I (single trigger group)
that included 80 women who received triggering in the form of 10,000 IU of HCG intramuscular
injection. Group II (Dual trigger group) that included 80 women who received triggering in
the form of 10,000 IU of HCG intramuscular injection in addition to GnRH agonist triptorelin
0.2 mg subcutaneously.
Ovum pickup was done 34 hours after triggering under the guidance of transvaginal ultrasound.
ISM1 culture medium was used for oocyte collection and embryo culture. Transabdominal
ultrasound guided embryo transfer was done 3 days after oocyte retrieval using Labotect
semirigid catheter by the same expert operator
Cycle cancellation was done if day 9 folliculometry revealed less than 2 mature follicles, no
oocytes were retrieved or if fertilization failed
Luteal phase support was started in all women on the day of oocyte retrieval and continued
till the day of serum β-hCG assessment (done 14 days after ET) through administration of 400
mg of natural Progesterone twice daily per vagina . In women with +ve serum β-hCG (> 5
mIU/ml), transvaginal ultrasound evaluation was done 4 weeks after ET to confirm the presence
and number of intrauterine gestational sacs.