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Meta-Analysis
. 2023 Mar 30;27(1):112-119.
doi: 10.5935/1518-0557.20220035.

Dual trigger vs. Conventional trigger outcomes in In Vitro Fertilization. Systematic review and meta-analysis

Virginia González González  1 , Alejandra Mayoral Triana  1 , Irene Serrano García  1 , Sara Osado Nieto  1 , Marta Calvo Urrutia  1 , Ignacio Cristóbal García  1 , Teresa Gastañaga-Holguera  1
Affiliations
Meta-Analysis

Dual trigger vs. Conventional trigger outcomes in In Vitro Fertilization. Systematic review and meta-analysis

Virginia González González et al. JBRA Assist Reprod. .

Abstract

Objective: The aim of this study is to analyze the efficacy of the dual trigger (human chorionic gonadotropin (hCG) + GnRH agonists) compared to the conventional trigger (hCG) in terms of oocyte retrieval (number and oocyte maturity), fertilization rate or number of embryos with two pronuclei, number of high-quality embryos, number of transferred embryos, number of cryopreserved embryos, implantation rate, positive β-hCG rate, ongoing pregnancy rate, abortion rate, and live birth rate.

Methods: This search performed in this systematic review included all literature published in the PubMed database of studies on controlled ovarian stimulation with dual trigger compared with conventional trigger. The meta-analysis included clinical trials and prospective cohort studies.

Results: Statistically significant differences between groups (dual trigger vs. hCG trigger) in terms of number of oocytes retrieved and live birth rate favored the dual trigger protocol. No statistically significant differences were found in the other studied variables. A tend favoring the dual trigger protocol was observed in all studied parameters.

Conclusions: Dual trigger seems to be more effective in GnRH antagonist cycles in terms of embryo and pregnancy outcome.

Keywords: GnRH agonist; conventional trigger; dual trigger; in vitro fertilization; oocyte maturation.

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Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Risk-of-bias summary. A: Methodological quality items for each included study B: Methodological quality items presented as percentages across all included studies.
Figure 3
Figure 3
Forest plots comparing primary outcomes between dual triggering and hCG-alone triggering. A: Number of oocytes retrieved. B: Number of mature oocytes (MII) retrieved. C: Number of two pronuclei (2PN) embryos obtained. D: Number of high-quality embryos.
Figure 4
Figure 4
Forest plots comparing secondary outcomes between dual triggering and hCG-alone triggering. A: Number of embryos transferred. B: Implantation rate. C: Beta-HCG rate. D: ongoing pregnancy rate. E: New born rate.
See this image and copyright information in PMC

References

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