Abstract:

The choice of appropriate trigger methods in the controlled ovarian hyperstimulation (COH) of assisted reproductive technology (ART) is crucial. With the in-depth study of the pros and cons of human chorionic gonadotropin (hCG) trigger and gonadotropin-releasing hormone agonist (GnRH-a) trigger, the dual trigger, defined as the combined trigger with GnRH-a and hCG, was proposed and applied in clinical practice in order to reduce the incidence of ovarian hyperstimulation syndrome (OHSS) and improve the outcome of ART. However, due to the heterogeneity of different patients in age, ovarian reserve, body mass index (BMI), etc., the application of dual trigger may produce varying degrees of effect, in the patients with high, normal and low ovarian response. This review summarizes the research progress of dual trigger, so as to provide a reference for the selection of trigger methods in the patients with different ovarian responses. We also discuss the directions for further research on the dual trigger, such as trigger doses, the timing of oocyte retrieval, the individualized luteal phase support, and new trigger methods.

Key words: Superovulation, Ovarian hyperstimulation syndrome, Reproductive techniques, assisted, Chorionic gonadotropin, Gonadotropin-releasing hormone agonist, Dual trigger