Comparison of Oocyte Maturation Trigger Using Follicle Stimulating Hormone Plus Human Chorionic Gonadotropin versus hCG Alone in Assisted Reproduction Technology Cycles

Objective The success rates of assisted reproduction technology (ART) could be developed with the improvement of ovarian stimulation protocols as well as the optimization of final oocyte maturation. The goal of this study was to compare oocyte maturation, fertilization and pregnancy rates among women with concomitant FSH administration at the time of hCG trigger and the hCG trigger alone. MaterialsAndMethods In a randomized controlled trial 109 infertile women at the age between 20 to 40 years, underwent GnRH antagonist protocol and fresh embryo transfer were randomly divided into two groups on the day of trigger. In the first group, final oocyte maturation was done by 5000 IU hCG (Pregnyl, Organon, Netherlands) plus 450 IU FSH (Cinnal-f Cinnagen, Iran). In the control group, oocyte triggering was performed by 5000 IU hCG alone. The primary outcome was clinical pregnancy and the secondary outcomes included oocyte recovery rate, oocyte maturity rate, fertilization proportion rate, fertilization rate, implantation rate and chemical pregnancy rate. Results 54 women were allocated to the group with the FSH bolus injection at the time of hCG administration and 55 women assigned to the hCG alone administration group. Women in the FSH group had a significantly higher MII oocyte (7.17±3.50 vs. 5.87±3.19), 2PNs (5.44±3.20 vs. 3.74±2.30) and total embryos (4.57±2.82 vs. 3.29±2.13) compared to hCG alone group respectively. Furthermore, fertilization rate (0.75±0.19 vs. 0.68±0.25), implantation rate (14.2% vs. 8.5%) as well as clinical (27.9% vs. 15.9%) and chemical (32.6% vs. 20.5%) pregnancy rates were higher in FSH group, but no statistically significant difference was found (P>0.05). Conclusion Combination of FSH and hCG for oocyte triggering improves oocyte maturity and fertilization proportion rate without increasing the chance of implantation, chemical and clinical pregnancy rates.