Fertility preservation cycles: Comparing GnRH agonist and dual triggering effects on oocyte retrieval and maturation rates
Chen Nahshon, Efrat Yanai, Wisam Assaf, Nir Kugelman, Nadav Cohen, Sivan Skvirsky, Shirly Lahav-Baratz, Idit Blais, Galia OronBackground
In GnRH antagonist IVF cycles, final oocyte maturation can be triggered using either a GnRH agonist or dual triggering. While GnRH agonist triggering reduces the risk of ovarian hyperstimulation syndrome and is commonly used in fertility preservation cycles, concerns remain regarding its potential impact on the number of oocytes retrieved and maturation rates.
Objective
To study whether the number of oocytes retrieved, and maturation rates are affected by triggering type in GnRH antagonist cycles for fertility preservation.
Design
Retrospective cohort study.
Methods
This retrospective study included 325 fertility preservation cycles at our IVF unit between the years 2020-2024. All fertility preservation of oocytes and embryos were included. The primary outcome was the association between the type of ovulation triggering and the number of oocytes retrieved. Secondary outcomes were associations with maturation rates.
Results
Mean age of patients (33.9±4.6, 34.4±3.4, p=0.41) and basal FSH levels (7.6±2.8, 9.5±5.0; p<0.001) were lower in the GnRH agonist triggering group compared to the dual triggering group, respectively. The number of oocytes retrieved was higher in the GnRH agonist group (15.2±8.7, 8.9±6.6, p<0.001) compared to the dual triggering group, yet in a multivariate model this correlation was not significant. Maturation rates did not differ between the two triggering groups (p=0.69, p=0.61). In a multivariable regression analysis, within the dual trigger group, higher basal LH was found to be associated with a lower number of mature oocytes retrieved (p=0.017).
Conclusion
After adjustment for measured baseline and stimulation characteristics, trigger type was not independently associated with the number of oocytes retrieved or oocyte maturation rates in fertility preservation cycles. These findings should be interpreted with caution given the retrospective study design and potential residual confounding. Prospective studies are warranted to confirm these findings.