TITLE:
GnRH-Agonist Trigger versus Human Chorionic Gonadotrophin (HCG) Trigger in Cases of Controlled Ovarian Stimulation; Randomized Controlled Trial
AUTHORS:
Mohamed Elmahdy, Suzan Elsharkawy
KEYWORDS:
GnRH Agonist, HCG, Ovulation Trigger, OHSS
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.11,
November
10,
2021
ABSTRACT: Objectives: The aim of the study was to compare the efficacy and safety
of GnRH-agonist to the human chorionic gonadotrophin (HCG) trigger in cases of
simple ovarian stimulation. Study design: Randomized controlled trial was conducted on 291 women
complaining of unexplained infertility visiting Elshatby Maternity University
Hospital from February to December 2019. Trial registration unique ID is PACTR202001787868341 (https://www.pactr.org/). Age included from 20 - 43
years. All patients were stimulated by the sequential stimulation protocol
using letrozole then FSH injection, when the criteria of ovulation trigger were
reached; cases were randomized into two groups using closed envelopes method. Group A
(123 cases) GnRh agonist (triptorelin 0.2 IU) subcutaneous injection and Group
B (168 cases) HCG 10,000 IU intramuscular injection were used for triggering of ovulation then followed by timed intercourse. Results: Primary
outcome was the clinical pregnancy rate while rate of miscarriage and ovarian
hyper-stimulation rate were the secondary outcome. Clinical pregnancy rates, in
Group A were (21.1%) while it was (31.5%) in another group (P = 0.049). Miscarriage
rate was (4.9%) in the first group and (3.6%) in the second group (P = 0.580).
Except for one case of moderate ovarian hyper-stimulation syndrome (OHSS)
complicated the HCG group, there were no such cases in GnRH group. Conclusion:
Triggering final oocyte maturation with HCG was superior to GnRH agonists
triggers as regards the clinical pregnancy rate.