DOES DUAL TRIGGER WITH COMBINATION OF GONADOTROPIN-RELEASING HORMONE AGONIST AND LOW DOSE HUMAN CHORIONIC GONADOTROPIN IMPROVES CLINICAL OUTCOMES IN NORMAL RESPONDERS IN GnRH ANTAGONIST IVF-ICSI CYCLES

Clinical outcomes of dual trigger containing gonadotropin-releasing hormone agonist (GnRHa) and low dose human chorionic gonadotropin (hCG) compared with the standard for final oocyte maturation in normal responder patients GnRH Antagonist IVF-ICSI Cycles. A single centre prospective randomized comparative study conducted at a tertiary care infertility , Akanksha IVF centre, Janakpuri, New Delhi from 1st March 2020 to 28th February 2021. 80 defined as women age group 21 37 year, serum AMH level >1.2 ng/ml < 4ng/ml AFC (3- 8) per ovary who were undergo controlled ovarian hyperstimulation (COH) cycles, by computer based program into 2 groups 40 each. All underwent stimulation starting recombinant FSH dosage 150-225 IU on D2 adjusted according follicular monitoring After least one follicle reached size 14mm antagonist Inj Cetrorelix 0.25 mg started subcutaneously daily. When > follicles 18 mm was triggered either Leuprolide acetate 2000 highly purified Inj. hCG Group 1 or 10000 inj Group2. Oocyte retrievals performed 35 36 hours after trigger. all cases. Day 3 fresh embryo transfers cases (2 x 8cell embryos).The luteal phase support vaginal supplementation 800 micronized progesterone. Serum beta after14 days transfer . Primary outcome measured clinical pregnancy rate secondary were: implantation rate, miscarriage number MII oocytes picked up, embryos formed, risk OHSS. In (52.50% vs 47.50% ) (29.67% 26.08% higher than but difference not statistically significant. Miscarriage lesser (14.28%) (15.78%) it also significant There up formed group1/ (10.63+5.46 8.2+3.4 respectively (8.10+5.74 6.8+3.6 respectively) this No OHSS reported 1/ group. Though there increased group1 .There increase (p value .0064 .0 156 no