Gonadotropin releasing hormone (GnRH) agonist is sufficient for triggering final oocyte maturation in GnRH antagonist protocol and can significantly reduce incidence of ovarian hyperstimulation syndrome (OHSS) in high-risk patients. However, lower oocyte yield was reported in patients with lower luteinizing hormone (LH) level post trigger with single injection of GnRH agonist, which might be related to the shorter duration and lower amount of LH induced by GnRH agonist. Our aim is to study dual trigger with GnRH agonist and human chorionic gonadotropin (hCG) for preventing OHSS and maintaining clinical outcome in high risk patients who receive controlled ovarian stimulation in GnRH antagonist protocol.
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clinical pregnancy rate per transfer cycle
Timeframe: 1month post embryo transfer
numbers of patients having OHSS
Timeframe: 2 weeks post trigger with dual GnRHa
oocyte yield
Timeframe: oocyte retrieval day (34 to 38 hours post trigger with GnRHa and hCG)
Oocyte maturity
Timeframe: 24 hours post oocyte retrieval day