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Ginecología y obstetricia de México

versión impresa ISSN 0300-9041

Resumen

KABLY-AMBE, Alberto et al. Doubble Trigger in patients with a normal response with a low percentage of mature oocytes. Ginecol. obstet. Méx. [online]. 2020, vol.88, n.4, pp.244-251.  Epub 30-Ago-2021. ISSN 0300-9041.  https://doi.org/10.24245/gom.v88i4.4091.

OBJECTIVE:

To evaluate the effect of double trigger in patients with a previous cycle with less than 65% of mature oocytes compared to the captured oocytes, in a normorresponding population with induction of ovulation with recombinant or urinary hCG.

MATERIALS AND METHODS:

A prospective cohort study, conducted in patients diagnosed with infertility, treated with in vitro fertilization, evaluated at the Mexican Fertility Center (Hospital Angeles Lomas) between 2017 and 2019. The treatment was carried out in the same patient, in whose previous conventional cycle with antagonist scheme and induction of ovulation with hCG had suboptimal ovarian response and oocyte capture with less than 65% in M2 phase (Group 1). Subsequently, a second cycle was performed with the same scheme of gonadotropins and induction of ovulation with double shot: 1 mg triptorelin acetate + 5000 IU of urinary hCG 40 and 34 hours prior to capture (Group 2 or double trigger). Percentage and quantity of oocytes captured in M2 phase were evaluated.

RESULTS:

34 patients were registered, in whom 68 cycles were performed. The number of oocytes captured was greater in group 2 (agonist of GnRH + urinary hCG; p = 0.03). The double shot increased the percentage of mature oocytes 65.4 ± 21.3 vs 74.6 ± 20.2 (p = 0.07).

CONCLUSIONS:

The double trigger technique is valuable for the treatment of patients with poor oocyte capture, even with normal follicular development and adequate and optimal hCG estradiol concentrations on the day of capture. Large prospective studies are required to elucidate the aforementioned recommendation of the “double shot” technique.

Palabras llave : Double trigger; In vitro fertilization; GnRH agonist; Oocyte maturation: hCG.

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