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

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