Ovulation triggering with hCG alone, GnRH agonist alone or in combination? A randomized controlled trial in advanced-age women undergoing IVF/ICSI cycles

What Was Tested

The paper reports a study of hCG (human chorionic gonadotropin) and Triptorelin, published as a randomized controlled trial.

Few studies have however been conducted to compare a dual trigger with a single GnRHa trigger, and insufficient evidence exists to support which trigger can achieve the best outcomes in IVF patients aged ≥35 years.

Why It Was Studied

Women of advanced age are quite a heterogeneous population and overlap with poor ovarian responders or patients with diminished ovarian reserve.

The researchers therefore could not entirely exclude selection biases or confounding factors.

Who Took Part

According to the abstract, 510 participants were involved.

PubMed tags the participants as women only.

This was an open-label randomized controlled trial of 510 participants conducted at single reproductive medical center from January 2019 to December 2021.

After a sample size calculation performed by retrospectively analyzing their previous clinical data, the researchers planned to recruit 170 patients in each group and 510 patients in total for the study.

How the Study Was Run

The researchers set it up as a randomized, double-blind, open-label and placebo-controlled study.

Because people in this hCG (human chorionic gonadotropin) study were split into groups at random, differences between the groups are less likely to reflect who happened to join each one.

As a double-blind hCG (human chorionic gonadotropin) study, the assignments were hidden from both participants and investigators until the end.

Everyone knew when hCG (human chorionic gonadotropin) was being given (open label), which is simpler to run but leaves more room for expectations to affect what is reported.

The comparison arm used a placebo, so changes seen with hCG (human chorionic gonadotropin) could be set against what happens without it.

Women aged ≥35 years undergoing IVF/ICSI treatment, receiving a non-pituitary down-regulation protocol, and with low risk of OHSS, were enrolled in this trial.

The primary outcome parameter was the number of retrieved oocytes.

The secondary outcome parameters included, among others, the number and rates of mature oocytes, two pronuclei (2PN) embryos and good-quality embryos, as the rates of OHSS, clinical pregnancy, miscarriage and live birth.

What Was Measured

PubMed files the paper under topics including China, Chorionic Gonadotropin, Fertilization in Vitro, Gonadotropin-Releasing Hormone, Ovarian Hyperstimulation Syndrome, Ovulation and Ovulation Induction.

The authors tagged it with the keywords GnRH agonist, IVF, dual trigger, human chorionic gonadotropin and oocyte maturation.

What This Means in Plain Language

The paper is a randomized, double-blind and open-label study of hCG (human chorionic gonadotropin) and Triptorelin in 510 participants.

With several hundred people or more, it is a fairly large study for this kind of research.

Results are reported in around 7 sentences of the abstract; we leave them to the paper itself rather than summarise them.

The publication is from 2022 (Human reproduction (Oxford, England)), a journal based in England.

More context: the hCG (human chorionic gonadotropin) compound page and the Triptorelin compound page, all human trials.